Principal Engineer

Fusion Health is seeking a Principal Engineer who leads by doing. You will own complex, end-to-end technical work across distributed systems, unblock teams, and help set the direction for how we build. This is a hands-on role with real architectural influence, not a title that floats above the work.

About Fusion Health
Most healthcare software is built for the easy cases. Fusion Health builds for the rest.

We support clinicians working in movement restricted communities, where care delivery is more complex and software reliability is critical. In these environments, systems need to work consistently because there is no room for failure. This has been our focus since 2006.

That is not an accident. It is who we hire.

Bryan Jakovcic(EY Entrepreneur of the Year) built this company and still personally interviews every single person who joins it. Because the people here are not a department or a headcount. They are the company. Fusion has been recognized by INC as one of the fastest-growing private companies in the United States for four consecutive years, including #8 in New Jersey and #38 in the NY Tri-State area, and by Deloitte on its Fast 500 list of fastest-growing technology companies in the United States. We are also proud to be certified as a Great Place to Work by Fortune!. That growth and recognition happened because the right people showed up and did something with it.

We are driven, self aware, and we own what we do. That is the culture. No more, no less.

If this is the kind of work you've been looking for, this is where you do the best work of your career.

What we offer:

• Medical, dental, and vision coverage
• 401K
• Generous PTO

Our teams are based in Woodbridge, NJ and Topeka, KS. We operate in a hybrid environment.

What You’ll Do

• Design and implement scalable backend systems and APIs in C#/.NET, with clean architecture and high testability.
• Lead end-to-end delivery of complex, multi-team technical initiatives from design through production.
• Own architectural decisions in your domain and contribute to cross-team standards and patterns.
• Dig into critical issues, performance bottlenecks, and technical debt, and drive them to resolution.
• Build and maintain cloud workloads on Azure with a focus on reliability, cost efficiency, and operability.
• Contribute to observability: distributed tracing, structured logging, and SLO-driven operations.
• Mentor engineers across the team, raising the quality of code, design, and technical thinking.
• Partner with engineering leads and product to align technical work with business outcomes.

Who You Are

• 7-10+ years of software engineering experience, with a track record of leading complex technical work across teams.
• Strong, hands-on proficiency in C# and ASP.NET Core, building production backend services and APIs.
• Solid experience with distributed systems: service decomposition, event-driven patterns, and designing for failure.
• Hands-on experience with Microsoft Azure across compute, messaging, identity, data, and API management.
• Solid experience with SQL Server or Postgres, including data modeling and query performance tuning.
• Familiar with observability tooling: OpenTelemetry, distributed tracing, structured logging, SLOs and SLIs.
• Experience with Docker, Kubernetes/AKS, and CI/CD pipeline design.
• Able to evaluate and communicate trade-offs clearly to both technical and non-technical stakeholders.
• Experience in regulated or high-reliability industries (healthcare, finance, public sector) is a plus.

Additional Details:

• This is an on-site (hybrid), full-time, salaried position. Our normal hours of operation are Monday – Friday, 8:00 AM – 4:00 PM.
• This position description is not intended to be exhaustive, and other duties may be assigned as they arise.
• It is not expected that applicants have any familiarity with Fusion’s proprietary applications, Healthcare software, or Corrections/Public Health business processes. Qualified candidates will be able to demonstrate related experience and transferable skills that will work well with the Fusion team.
• At this time, this position is not eligible for employment sponsorship.
• Fusion is an equal employment opportunity employer.

Compensation

• Salary Range: $160,000- $200,000.
• At Fusion, our salary ranges are designed to be competitive within our size and industry. Compensation is just one component of a comprehensive total rewards package that also includes benefits, flexibility, and growth opportunities.
• Individual pay decisions are informed by several factors, including location, experience, qualifications, skillset, and internal equity across the organization. While we expect most offers to fall within the stated range, each compensation decision is made thoughtfully, with consideration for both the candidate’s unique profile and our commitment to pay parity.