Remote Ruby Rails Developer Jobs in Durham, NC (NOW HIRING)

Location: U.S. Remote
Compensation: $190K-$200K base + bonus + equity
Schedule: Flexible hours with PST overlap
Travel: None

Our client is a growth-stage healthcare technology company that has raised more than $100 million and is scaling quickly. We're hiring a Senior Full Stack Engineer to help build the core platform behind healthcare operations affecting hundreds of thousands of patient visits each year.

You'll join a lean, flat engineering team where senior engineers have broad ownership and direct access to product and company leadership. You won't be limited to a narrow layer of the stack or handed a queue of isolated tickets. You'll own meaningful systems end to end, influence architecture, and help shape the technical roadmap for their next stage of growth.

The direct users of these systems are often internal healthcare operations teams, but their impact reaches patients, clinicians, and health-plan partners. This is an opportunity to do hands-on work with real operational consequences-and participate in the upside through equity as the company continues to grow.

• Build and operate production applications, APIs, integrations, data workflows, and internal user experiences.
• Work across a polyglot stack that includes Ruby on Rails, Python, Node.js, SQL, and adjacent services.
• Design reliable systems for sensitive healthcare data, with attention to data quality, auditability, performance, concurrency, and failure handling.
• Own features from problem definition through launch, production support, and iteration.
• Partner directly with product and leadership to define milestones, surface tradeoffs, and improve engineering standards.
• Improve delivery, CI/CD, observability, and operational reliability alongside feature development.
• Use AI coding tools such as Claude Code, Cursor, or Codex to accelerate delivery while maintaining strong testing and review practices.

• 7+ years building and operating production software, or equivalent Senior-level scope.
• Strong hands-on experience in Ruby on Rails or Python, plus the ability to work confidently across multiple languages and systems.
• Strong SQL and data-modeling skills, including PostgreSQL or similar relational databases.
• Experience with JavaScript/TypeScript and modern web application development.
• Strong engineering fundamentals: data structures, complexity, concurrency, API design, testing, and systems design.
• Experience building reliable integrations, data pipelines, or high-volume operational systems.
• Working knowledge of DevOps practices, including CI/CD, Docker, cloud infrastructure, monitoring, and incident response.
• Clear examples of using AI coding agents responsibly, including how you validate their output.
• A computer science degree or equivalent foundation in core software-engineering principles.
• U.S. work authorization without sponsorship.

• Healthcare, regulated-data, insurance, or operations-platform experience.
• Experience with AWS, Kubernetes, event-driven systems, or distributed services.
• Experience with C#, analytics systems, or data-warehouse tooling.
• Experience improving and scaling systems already in production.

• Health, dental, and vision insurance
• 401(k)
• Generous PTO
• Direct access to leadership and fast decision-making
• Fully remote work with flexible hours
• Modern, AI-assisted engineering workflows

At Urrly, fairness matters. We use AI to review every application against the same clear requirements for the role. Candidates are evaluated only on job-related factors such as skills, certifications, and experience, not personal attributes.