Senior Full Stack Software Developer Jobs in Texas

Job Description:

We are seeking a talented and motivated Full Stack Software Developer to join our engineering team building mission-critical healthcare technology. In this role, you will design, develop, and maintain our suite of healthcare applications, including our Electronic Health Record (EHR) system and our end-to-end Revenue Cycle Management (RCM) platform - spanning the complete clinical-to-financial workflow from provider documentation and charge capture, through claim submission to commercial payers and Medicare, to payment posting, denial management, bank reconciliation, and integration with accounting systems for revenue tracking.

This is a hands-on engineering role for someone who is comfortable owning features from requirements through deployment, takes pride in writing clean, maintainable code, and is excited about both leveraging AI-assisted development tools and building AI-powered features directly into our products.

Key Responsibilities: 

• Design, develop, test, and maintain features across our EHR and RCM platforms using PHP, JavaScript, HTML, CSS, SQL, and Python.
• Build software supporting the full healthcare lifecycle - from clinical documentation and note generation, through coding and charge capture, claim submission to commercial payers and Medicare/Medicaid, ERA/EOB processing, payment posting, denial management, bank reconciliation, and revenue reporting integrations with accounting platforms.
• Build responsive, accessible front-end interfaces and robust back-end services that handle protected health information (PHI) securely and reliably.
• Develop and maintain integrations with healthcare standards and third-party services (e.g., clearinghouses, payer systems, lab interfaces, banking/ERA feeds, and accounting software).
• Design and implement AI-powered features within our products - such as clinical documentation assistance, ambient note generation, coding suggestions, denial prediction, automated claim scrubbing, or intelligent workflow automation - with appropriate guardrails for accuracy, privacy, and compliance.
• Write efficient, well-structured SQL queries, stored procedures, and schema designs to support clinical and financial workflows.
• Participate in the full software development lifecycle: requirements analysis, technical design, implementation, code review, QA, deployment, and post-release support.
• Collaborate closely with product managers, designers, QA engineers, and clinical/billing subject-matter experts to translate complex healthcare workflows into intuitive software.
• Track work, document decisions, and manage tickets in JIRA; contribute to sprint planning, estimation, and retrospectives in an Agile environment.
• Effectively use AI coding assistants (e.g., Claude Code, Cursor) to accelerate development, refactor legacy code, generate tests, and improve overall engineering productivity - while applying sound judgment to ensure correctness, security, and compliance.
• Identify and remediate performance bottlenecks, technical debt, and security vulnerabilities in existing applications.
• Help uphold and improve our HIPAA-aligned security and privacy practices across the codebase and SDLC.
• Mentor junior developers through code reviews, pair programming, and knowledge sharing as you grow on the team.

Required Qualifications:

• Must be willing to work a hybrid schedule from our office in Houston, TX
• Must be authorized to work for any employer in the US without restriction
• 3-5 years of professional experience designing and developing production web applications.
• Demonstrated experience shipping features end-to-end in a team-based, Agile environment.
• Strong proficiency in PHP for server-side application development.
• Solid JavaScript skills, including modern ES6+ features and experience with at least one front-end framework or library.
• Proficiency with HTML5 and CSS3, including responsive design and cross-browser compatibility.
• Strong SQL skills with at least one major relational database (MySQL preferred; experience with MariaDB, PostgreSQL, or MS SQL Server also acceptable), including query optimization and schema design.
• Working proficiency with Python for scripting, automation, data processing, or back-end services.
• Experience with Git-based version control workflows (branching, pull requests, code review).
• Comfort working in Linux-based environments and with REST APIs (designing, consuming, and debugging).
• Hands-on experience using AI coding assistants such as Claude Code, Cursor, or comparable tools as part of a daily development workflow.
• Practical experience implementing AI/LLM-powered features in production software - e.g., integrating with model APIs (Anthropic, OpenAI, or similar), prompt engineering, retrieval-augmented generation (RAG), function/tool calling, or building agentic workflows - with awareness of cost, latency, evaluation, and safety considerations.
• Experience using JIRA (or equivalent tools such as Azure DevOps or Linear) for issue tracking, sprint management, and project visibility.
• Familiarity with Agile/Scrum methodologies, code review practices, and CI/CD concepts.
• Working knowledge of HIPAA Privacy and Security Rule requirements as they apply to software development, including handling of PHI, audit logging, access controls, and minimum necessary use.
• Understanding of common healthcare data and workflow concepts: patient demographics, encounters, clinical documentation, charting, and the full revenue cycle (eligibility charge capture coding claim submission ERA/EOB processing payment posting denial management patient collections bank reconciliation revenue reporting).

Preferred Qualifications:

• 1-3 years of hands-on experience building or maintaining healthcare-related software, such as EHR/EMR systems, end-to-end RCM/medical billing platforms, practice management systems, or clinical workflow tools.
• Production experience with Vue.js (Vue 2 or 3), including component architecture, state management (Vuex/Pinia), and the Composition API.
• Experience with CakePHP (3.x or 4.x+); familiarity with other modern PHP frameworks (Laravel, Symfony) is a plus.
• Hands-on experience with healthcare interoperability standards such as HL7 v2, FHIR, X12 EDI transactions (837, 835, 270/271, 276/277), and CCDA documents.
• Familiarity with medical coding systems (ICD-10, CPT, HCPCS) and payer/clearinghouse integrations.
• Experience integrating with banking systems and accounting software (e.g., QuickBooks, NetSuite, Sage) for reconciliation and revenue tracking.
• Experience working in environments subject to SOC 2, HITRUST, or similar compliance frameworks.
• Experience writing automated tests (unit, integration, end-to-end) and contributing to a strong testing culture.
• Exposure to containerization (Docker), cloud platforms (AWS, Azure, or GCP), and CI/CD pipelines.
• Experience building production-grade AI features in healthcare or other regulated domains, including evaluation harnesses, prompt/version management, handling PHI in AI workflows, and applying appropriate human-in-the-loop safeguards.
• Bachelor's degree in Computer Science, Software Engineering, or a related field, or equivalent practical experience.

Details:

• Pay: $90,000-$125,000 annually, depending on experience
• This position will be a full-time, hybrid position
• Health, Dental, Vision Insurance
• Generous 401k plan
• Paid time off and holidays
• Life Insurance
• Education stipend 

(Skilled Wound Care is an equal opportunity employer and does not discriminate on the basis of race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), national origin, age (40 or older), disability or genetic information).