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Director, Development

Location: Remote – U.S.

Altera TouchWorks is seeking a high-impact Director, Development to lead multiple engineering teams responsible for building, modernizing, and sustaining software solutions for our ambulatory healthcare EHR business. Reporting directly to the Vice President, R&D, this role will be part of and leading our engineering organization focused on AI-directed development practices while sustaining delivery excellence across an active product portfolio. The successful candidate will bring strong Healthcare IT product engineering experience with a proven ability to scale teams, improve velocity, elevate quality, and operationalize AI-directed software development as a core engineering discipline - not merely a productivity add-on. This means governing the quality and correctness of AI-generated code output, enforcing architecture as the authoritative source of truth for all engineering decisions, and building the organizational capability to develop and deploy specialized clinical AI agents. This leader will partner closely with Product Management, Architecture, QA, Cloud Operations, Support, Client Services, and executive leadership to align roadmap priorities, deliver customer value, improve operational efficiency, and position TouchWorks for long-term growth. The ideal candidate combines deep Healthcare IT domain expertise, strong people leadership, operational discipline, and technical credibility. They must be comfortable leading geographically distributed teams - managing multi-timezone delivery cadences and multiple consulting vendor relationships - while building a high-performance culture centered on accountability, urgency, innovation, collaboration, and customer value. This role sits at the intersection of strategy and execution. The right candidate leads teams and drives results, while also rolling up their sleeves when the work demands it. If you are energized by transformation, comfortable operating in ambiguity, and motivated by building something new, this is the role for you.

Key Responsibilities

• Engineering Leadership & Delivery: Lead multiple software engineering teams delivering healthcare product enhancements, cloud-native modernization programs, regulatory initiatives, and client commitments across two parallel delivery tracks. Own end‑to‑end software delivery across planning, execution, quality, release readiness, production stability, and continuous improvement. Drive predictable execution through Agile delivery models, effective planning, clear priorities, and disciplined operating cadences. Ensure timely, high‑quality delivery of roadmap commitments, compliance requirements, customer escalations, and strategic business priorities.


• AI-Directed Software Development Champion and operationalize AI‑directed engineering practices as a core organizational capability – not a supplemental tool. This includes governing AI-generated code quality and correctness, enforcing architecture as the authoritative source of truth for all implementations, and building the team's ability to direct rather than simply write code. Operationalize AI engineering tools such as Claude Code, GitHub Copilot, and related platforms to improve engineering throughput, quality, and delivery speed. Establish metrics to track AI adoption, developer productivity, cycle time reduction, code quality, and ROI – including AI‑specific measures such as AI contribution rate, architecture conformance rate, and agent output velocity. Build governance models to ensure secure, compliant, and responsible use of AI in software engineering, with specific attention to HIPAA obligations around AI-generated code in clinical contexts and the handling of protected health information in AI workflows. Build and govern an emerging clinical AI agents capability – including ambient documentation, clinical decision support, and intelligent ordering agents – establishing safety controls, evaluation frameworks, and human‑in‑the‑loop review standards for AI agents operating in clinical workflows. We are looking for someone who has lived inside AI‑directed development, not observed it from a distance. The expectation is practical command: the ability to guide, evaluate, and drive AI-generated code and workflows at scale across the teams you lead.


• Technical Leadership: Provide architectural and technical guidance for modern healthcare platforms including cloud‑native services, APIs, interoperability, and data platforms. Enforce architecture‑as‑source‑of‑truth discipline across all engineering teams: every implementation must trace to a documented architecture artifact. Drive modernization of legacy systems toward scalable cloud‑native architectures and modern engineering patterns. Partner with Architecture, Product Management, Security, DevOps, and Support leaders on strategic priorities. Act as executive escalation point for critical technical risks, delivery issues, and customer‑impacting events.


• People Leadership: Recruit, develop, coach, and retain high‑performing engineering managers, architects, and senior engineers. Establish clear goals, accountability models, career development plans, and succession planning. Foster a high‑performance culture centered on ownership, collaboration, urgency, and continuous improvement. Lead a geographically distributed organization across U.S., Costa Rica, and India, managing multiple consulting vendor relationships and multi‑timezone delivery cadences effectively. The Director leads through people and stays close to the work. We expect this leader to understand what the teams are building at every level and to step in when the moment calls for it. The standard here is ownership, not delegation.


• Operational Excellence: Manage budgets, headcount planning, vendor utilization, and cost optimization across a mixed workforce of direct employees and consulting resources. Improve engineering goals including sprint predictability, defect escape rate, employee engagement, and release quality – alongside AI‑specific metrics including AI contribution rate, architecture conformance, and agent output quality. Standardize engineering processes, tooling, scorecards, and governance mechanisms across both sustaining and greenfield delivery tracks.

Job Requirements

• Education: Bachelor's degree in Computer Science, Engineering, or related field required. Master's degree preferred.


• Salary Range: $150,000 - $165,000

About Altera Digital Health

A global healthcare IT innovator, Altera Digital Health develops and elevates technology to connect and inspire healthier communities. Our platform approach to our solutions is changing the way healthcare is delivered. By keeping the human user at the center of our design methodology, we are supporting caregivers and helping patients meet and exceed their wellness goals. Together, with our clients, we’re driving a new era of healthcare.

Equal Opportunity Employer

Altera is an Equal Opportunity/Affirmative Action Employer. We consider applicants without regard to race, color, religion, age, national origin, ancestry, ethnicity, gender, gender identity, gender expression, sexual orientation, marital status, veteran status, disability, genetic information, citizenship status, or membership in any other group protected by local law.

If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact us at: HR.Recruiting@AlteraHealth.com To learn more, visit www.alterahealth.com.

Our commitment to fair and equitable hiring. As part of our recruitment process, we use artificial intelligence (AI) tools during the initial screening phase to help identify candidates whose qualifications most closely align with the requirements of the role. This technology supports efficiency and consistency in the early stages, but it never replaces human judgement. All subsequent evaluations and final hiring decisions are made by our recruitment professionals. AI does not make final hiring decisions.