Karuna Health is looking for a skilled and values-driven Ruby on Rails engineer to join us in our mission to transform how patients interact with the healthcare system. Karuna's software empowers patients to stay in touch with their care teams using the same channels they already use with friends and family. It also helps complex care teams seamlessly keep track of patient communications and build authentic relationships to drive better outcomes. We are currently working on tools to help expand the scope of tracking and coordinating communication at the scale of tens of millions of people, solving industry problems that have long been considered unsolvable. 

As a team, we’re committed to:

  • Making sure our impact on patients is positive and measurable
  • Investing in each other’s growth, both professionally and personally
  • Braving uncertainty, and providing space to make and learn from our mistakes
  • Transparency in our relationships with each other, our customers, and our investors
  • Keeping patient privacy and security top of mind
  • Building a culture that combines collaboration and ownership

If these values match the kind of company you’re looking for, and you’re excited to invest your time and talents with a group that is reshaping healthcare communications, we can’t wait to hear from you! You can learn more about the interview process here.

We also want you to know that you can be a great candidate even if you don't perfectly fit the mold we describe below, and you can have important skills we haven't even thought of yet. If that's you, don't hesitate to apply and tell us about yourself.

We are a small team, and as we grow, we care deeply about building a workforce and culture that is inclusive and equitable for people of all backgrounds and experiences. Because of this, we particularly encourage people from communities that tend to be underrepresented to apply, including women, people of color, LGBTQIA people, veterans, and those with disabilities.

What you’ll be doing

  • Leading the design, architecture, and development of Karuna’s backend systems
  • Collaborating closely with a cross-functional product team of product management, design, and engineering on a mix of greenfield product development and improvements to our existing product suite
  • Working with a talented and thoughtful engineering team to help refine and improve Karuna’s engineering practices
  • Helping shape the team as we grow by being a core part of future hiring processes

What the first three to six months will look like

  • Helping us review and improve our current tech and infrastructure stack, as well as our current engineering practices
  • Jumping into the technical design and architecture of an ambitious new greenfield product for a major customer, and writing the code that will lay the foundation for its future
  • Working with the product team to rapidly iterate on well-designed features and functionality for existing customers
  • Learning about the health space and our customers, and meeting with everyone at the company to understand how our work fits together

What you need to be successful

  • Experience designing, building, and operating scalable back-end systems using Ruby on Rails
  • Experience with (and enthusiasm for!) incorporating automated testing into your development workflow
  • An approach of constant learning and curiosity, with a focus on growth and improving your craft as a software developer over time
  • A desire to invest in your teammates and be open with your knowledge and expertise
  • Empathy for your colleagues on and off the product team, and for the people whose lives are affected by your work
  • Enthusiasm for building high quality software that can meaningfully improve lives

Our current tech stack

Back-end: Ruby on Rails services behind a RESTful API abstraction, PostgreSQL, Redis, Amazon SQS, Google Protocol Buffers, Elasticsearch

Front-end: TypeScript, React and React Native, Redux

Dev tooling and infrastructure: GitHub, RSpec, CircleCI, Docker, Aptible, AWS, GCP, Sumo Logic, ScoutAPM, Sentry

More about us

Our team works together remotely (like most folks, we use Zoom and Slack extensively), but is primarily located in the San Francisco Bay Area. We’re excited to keep investing in excellent remote work culture and the flexibility it can provide.

We are a high-growth digital health company backed by first-class investors including First Round Capital, Slow Ventures, Founder Collective, and Lerer Hippeau. We’re happy to be supported by the same people who have helped other startups redefine their industries. We are working with and solving problems for some of the most influential health organizations in the world.


  • Company subsidized health insurance, flexible spending account, dental plan, vision plan, and commuter benefits
  • Company provided 401k (via Human Interest) for you to contribute to your retirement
  • Unlimited PTO that is actively used and encouraged, and flexible work hours
  • $1,000 budget (on top of standard laptop and equipment) to make your home work environment a comfortable, happy place
  • $1,000 annual budget for professional development expenses, including conference attendance, books, and online or in-person courses
  • Weekly reimbursable team lunches 
  • Access to career development and mentorship from our network of investors and partners

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