Remote Ruby Rails Developer Jobs in Nashville, TN

Open Position: Software Engineer - Survey Application
Location: Remote
Reports To: Sr. Director of Data Science and Insights
About Us:
At HST Pathways, we’re passionate about transforming healthcare. Our innovative software empowers surgery centers to provide care that’s not only more cost-efficient but also leads to better outcomes for patients. Backed by Bain Capital, we’re a profitable, fully remote SaaS company that’s growing quickly and entering an exciting new stage of expansion. With that growth comes opportunity—for us, our customers, and the people who join our team.
What We’re Looking For:
We’re looking for someone who is authentic, inspiring, and motivated to grow. You’re a quick learner who enjoys working in a fast-paced, evolving environment. You value diversity and inclusion and want to be part of a company that puts people first. Our values resonate with you, and you’re ready to embody them in your daily work.
In this role, you’ll roll up your sleeves and take on a high-volume workload with energy and enthusiasm. You are data-driven and results-oriented, but you also know the importance of building strong relationships and contributing to a positive team culture. Most importantly, you’re excited about the chance to make an impact—not only within our company but also in the broader healthcare community we serve.
Why Join Us:
At HST Pathways, you’ll find more than just a job — you’ll find a place to grow, contribute, and belong. We offer the flexibility of remote work and the stability of a well-backed, profitable company. You’ll collaborate with talented teammates who are passionate about healthcare innovation and committed to each other’s success.
Responsibilities:
We’re looking for a highly autonomous Full Stack Engineer to own and evolve a survey application built on Ruby on Rails. This role is ideal for someone who thrives in a high-ownership environment and is excited to leverage AI as a core part of the development workflow.
You’ll be the primary technical driver of the product—designing, building, and scaling features end-to-end—while using modern AI tools to accelerate development and expand what a single engineer can accomplish.

• Own the full lifecycle of the survey application (design, development, deployment, maintenance)
• Build and maintain features using Ruby on Rails across the full stack
• Architect and deploy cloud-native solutions on AWS (ECS, CloudFormation, load balancers, etc.)
• Design scalable, reliable backend systems and responsive user experiences
• Embrace an AI-first development strategy
• Evaluate and integrate emerging technologies, including voice AI and conversational interfaces
• Monitor performance, troubleshoot issues, and continuously improve system reliability
• Establish best practices for code quality, testing, and deployment as a solo engineer
• Deep experience using AI coding tools (e.g., Augment, ChatGPT, Cursor, Claude, etc.) in daily workflows
  • Ability to guide, review, and validate AI-generated code, not just generate it
  • Strong intuition for when and how to rely on AI vs. manual implementation
  • Interest in integrating AI capabilities (e.g., voice, NLP, automation) into products
• Mindset & Ownership
  • Comfortable operating as the sole engineer on a product
  • Strong problem-solving skills and ability to make architectural decisions independently
  • Eagerness to learn new technologies quickly (especially in AI/voice space)
  • Pragmatic and product-focused—able to balance speed with quality

• Strong experience with Ruby on Rails (5+ years preferred)
• Full stack development experience (frontend + backend)
• Hands-on experience building and deploying applications in AWS, including:
  • ECS (or similar container orchestration)
  • CloudFormation (or infrastructure-as-code equivalents)
  • Load balancers, networking, and scaling patterns
• Experience designing and maintaining production-grade systems

• Experience with voice AI platforms or conversational UX
• Experience with frontend development, especially React and NextJS
• Experience with CI/CD pipelines and DevOps best practices
• Startup or early-stage product experience

• One Team: We win together, support each other, and share credit.
• Inclusion: We respect differences and welcome every voice.
• Transparency: We’re open, honest, and clear about our goals.
• Agility: We move fast, test ideas, and learn as we go.
• Empathy: We listen, care, and anticipate others’ needs.
• Growth Mindset: We stay curious, keep learning, and aim to improve every day.
• Proactivity: We act thoughtfully, own outcomes, and bring our best selves to work.

• Remote work environment
• Health benefits paid for employees
• Flexible Paid Time Off Policy
• 11 company holidays per year
• Paid parental leave
• 401K with matching contributions
• Learning and development allowance
• A diverse, inclusive, and fun team!

HST Pathways celebrates diversity and is steadfast in fostering an inclusive work environment where employees feel valued, respected, and engaged. We champion and nurture a culture where inclusiveness is instinctive and fuels innovation, connection, and a strong sense of “One Team”. HST is deeply committed to representing and reflecting the unique experiences, perspectives and viewpoints of our employees, customers, and the communities we serve.

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