About Alto

We’re building a new kind of pharmacy to cure one of our healthcare system’s most startling ills: over 50% of prescriptions are never picked up. Because staying on track with doctor’s orders requires more than just delivering pills, we’re managing everything from insurance logistics to pricing, late-night questions to supply chain, and anything else that could stand in the way of effective treatment. Our more than 800 employees are dedicated to fulfilling medicine’s true purpose: to improve the quality of life for everyone who needs it. We’ve filled over 1 million prescriptions to date. To aid our calling, we’ve raised $354 million in funding, and we’re on track to achieve $1 billion in annual recurring revenue (ARR) by 2021. Join us as we prove just how much a pharmacy can deliver.

About the Team

We are looking for a senior backend engineer to be a key member of our quickly growing team. As an engineer at Alto, you will join a passionate team creating a completely new pharmacy experience from the ground up. By developing an integrated platform that includes patients and doctors, offering free same-day delivery, and building a pricing engine to ensure patients always get the best price on their medications, we are bringing pharmacy into the modern era and making high-quality healthcare accessible to all. As a backend engineer, you will have the opportunity to execute on a broad range of projects to build our pharmacy platform and enable our services to scale.

You are a backend specialist who owns projects from end-to-end, enjoys problem-solving, and values the impact your work makes on our patients. You are creative and resourceful, unafraid to dive into an unknown project but humble enough to correct mistakes and iterate. You are adept at breaking down complex problems and designing impactful software solutions that solve for scale, reliability, and extensibility.

Accelerate your Career as You Work on Projects such as:

  • Designing and implementing services to automate the pharmacy. We’ve built backend services to automate pharmacy billing and want to do the same for other complex systems such as intaking new prescriptions and fulfillment
  • Improving our drug database. At Alto, medications are at the heart of what we do. In order to offer patients the right medication at the right time at the best price, we need to integrate data on products from multiple data sources and surface the right data to patients, providers, and internal users of our platform. APIs to interface with the product database are integral to our ordering, inventory, billing, and delivery scheduling systems among many others. We’ve implemented the first version of the database, but need better systems to manage our products and the updates we receive to our data
  • Extending our clinical workflows to drive growth. Our vision is to provide a personalized pharmacy experience for every patient based on their needs. We’ve created best in class workflows for therapeutic areas like fertility, but in order to honor our company value to leave no patient behind, we’ll need to build clinical workflows and systems that support many more patients and their healthcare issues, whether they need help lining up their treatment plans, medication reminders, or a specific regimen of clinical follow-ups

A Bit About You:

  • Have 5+ years of experience writing production code
  • Have architected complex systems for long-term maintainability, performance, and reliability
  • Are proficient in one or more backend programming languages. (At Alto, we mainly use Ruby on Rails and Go on the backend, but experience with these specific languages is not required.)
  • Are adept at modeling and optimizing data stored in relational databases
  • Thrive in a collaborative fast-paced entrepreneurial environment. You're excited to dive into unfamiliar problems and humble enough to make mistakes and iterate


Alto Pharmacy is an Equal Opportunity Employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sexual orientation, national origin, genetic information, age, disability, veteran status, or any other legally protected basis. Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records. We are an E-Verify company.

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