Ruby on Rails Developer / Product Programmer

About the Company

We are a US-based ophthalmology group operating an internal healthcare operations platform used across multiple clinics.

The platform supports clinical workflows, billing workflows, reporting, inventory, employee workflows, internal tools, and integrations with healthcare and business systems.

This is real operational software used by real people every day. The work matters because it affects clinic teams, patient-related workflows, billing accuracy, reporting, and day-to-day healthcare operations.

Role Summary

We are looking for a practical Ruby on Rails Developer / Product Programmer to help maintain, improve, and extend our internal healthcare platform.

This is not a ticket-factory role. We are not looking for someone who only waits for fully specified Jira tickets and implements exactly what is written. We are looking for someone who can understand the problem, ask good questions, think through the tradeoffs, and deliver careful improvements.

The right person can operate as a “manager of one”: someone who can make forward progress independently, communicate clearly, and take ownership of a feature, bug, report, workflow, or production issue from investigation through delivery.

You will work in an existing Rails application with real business logic, real data, and real users. Some work will be new features. Some will be bug fixing. Some will be reporting, data cleanup, integrations, performance, security, or improving old code so the system is easier to work with next time.

The Kind of Work You’ll Do

To make this concrete, here are examples of the type of work this role may involve:

* Improve a billing workflow so clinic and finance teams can track the right information more reliably.

* Build or refine internal EHR-related workflows used by clinical and operations teams.

* Investigate why a report does not match expected operational or financial numbers.

* Add validations, auditability, or permission checks around sensitive workflows.

* Improve a slow PostgreSQL query or dashboard that staff rely on daily.

* Build a small internal tool that removes repetitive manual work.

* Fix a production bug by understanding both the code and the underlying business process.

* Work with operations users to understand what they are trying to do, not just what they clicked.

* Clean up confusing code in a way that makes future changes safer.

* Integrate with healthcare, billing, reporting, or business systems where needed.

* Improve background jobs, scheduled tasks, exports, or internal notifications.

* Add practical tests around important workflows.

* Help make the codebase calmer, clearer, and easier to change.

Technology Environment

The core application is built with Ruby on Rails and a relational database, with supporting frontend, background job, reporting, integration, and deployment tooling.

You should be comfortable working across a traditional full-stack Rails application, including:

* Ruby on Rails

* ActiveRecord

* PostgreSQL or similar relational databases

* Rails views and frontend code

* HTML, CSS, JavaScript

* Hotwire, Turbo, Stimulus, or similar Rails-friendly frontend patterns

* Background jobs and scheduled processing

* Git, pull requests, code review, and deployment workflows

* APIs and third-party integrations

You do not need to know every tool on day one, but you should be comfortable reading existing code, learning the system, and making careful changes in a production application.

Key Responsibilities

* Develop and maintain features in a Ruby on Rails application.

* Work on healthcare operations, internal EHR workflows, billing, reporting, inventory, HR, and administrative workflows.

* Understand existing business processes and translate them into practical system changes.

* Take ownership of features, bugs, reports, workflows, and production issues from investigation through delivery.

* Build and improve models, controllers, services, jobs, views, APIs, and internal tools.

* Write and tune PostgreSQL queries for reports, investigations, and data integrity work.

* Support frontend changes using Rails-native patterns, Hotwire/Turbo, Stimulus, JavaScript, HTML, and CSS.

* Integrate with third-party healthcare and business systems where required.

* Troubleshoot production issues and investigate bugs reported by users.

* Improve code clarity, reliability, security, performance, and maintainability.

* Participate in code reviews and help raise engineering standards.

* Handle sensitive healthcare-related data carefully and follow privacy and security expectations.

* Communicate progress, risks, tradeoffs, and blockers clearly.

What We’re Looking For

We are looking for someone who is calm, practical, and product-minded.

You should be the kind of developer who wants to understand why a feature matters, not just how to implement it. You should care about whether the workflow makes sense, whether the data is correct, whether the change is safe, and whether the next developer will understand what you built.

This role is a good fit if you:

* Like working on real business systems with real users.

* Are comfortable improving an existing application, not only building greenfield projects.

* Can work independently without needing every task broken down in detail.

* Know when to ask questions and when to make a reasonable decision.

* Can explain technical tradeoffs in plain language.

* Care about clear writing, clear code, and clear communication.

* Prefer simple, durable solutions over over-engineered ones.

* Are careful with sensitive, operational, and business-critical data.

* Can balance speed with correctness.

This role is probably not a good fit if you need a project manager to define every step, prefer only greenfield work, dislike debugging old code, or are uncomfortable working close to business operations.

Required Experience

* 3+ years of professional Ruby on Rails development experience.

* Strong understanding of Ruby, Rails conventions, ActiveRecord, MVC, and common Rails patterns.

* Experience working with PostgreSQL or similar relational databases.

* Comfortable reading, understanding, and improving an existing production codebase.

* Experience building or maintaining business applications with complex workflows.

* Able to debug production issues and reason through data problems.

* Comfortable with Git, pull requests, code reviews, and deployment workflows.

* Able to work independently and communicate clearly in writing.

* Careful and detail-oriented when working with sensitive or business-critical data.

* Good judgment around tradeoffs, scope, and maintainability.

Strong Plus

* Experience with healthcare, EHR, billing, insurance, revenue cycle, or regulated systems.

* Experience with Hotwire, Turbo, Stimulus, or modern Rails frontend patterns.

* Experience with Sidekiq or background job processing.

* Experience with AWS, Docker, Dokku, Linux, or production infrastructure.

* Experience with Elasticsearch or search-related features.

* Experience with APIs, webhooks, HL7, EDI, payments, reporting, or healthcare integrations.

* Experience with accounting-related workflows, financial data, or operational reporting.

* Experience improving application security, access controls, audit logs, or data protection.

* Experience with performance tuning and PostgreSQL query optimization.

* Experience working directly with business users, operations teams, or support teams.

Working Style

We value people who can manage themselves.

That does not mean working alone in silence. It means taking responsibility for moving the work forward: understanding the problem, writing down what you learned, proposing a path, asking for feedback, and delivering carefully.

Most communication will be written or async. Good writing matters because clear thinking often shows up as clear writing, clear pull requests, clear issue notes, and clear explanations.

You should be comfortable with:

* Written updates.

* Thoughtful pull requests.

* Clear bug reports and investigation notes.

* Asking focused questions.

* Explaining tradeoffs before making risky changes.

* Taking time to understand the existing system before changing it.

* Working with a small team where people are trusted to own their work.

How to Apply

Please include your resume and a short note explaining why this role is interesting to you.

In your note, please share one or two examples of relevant work you have done. Good examples could include:

* A Rails feature you owned end to end.

* A difficult production bug you investigated.

* A reporting or data integrity problem you solved.

* A complex business workflow you helped build.

* A legacy codebase you improved.

* An integration you designed or maintained.

* An internal tool you built for operations users.

Links to GitHub, open-source contributions, pull requests, technical writing, side projects, or relevant product work are welcome, but not required.

We care more about what you can do, how you think, and how you communicate than where you went to school or whether your previous title perfectly matches this role.