Staff Software Engineer

Tono Health builds software and operations for specialty care, starting with dermatology. The Staff Software Engineer will develop its EHR, patient portal, and platform infrastructure, including reliable AI tools that support clinicians.

Responsibilities:

• Own features end-to-end across a modern TypeScript monorepo: database schema design, Prisma migrations, tRPC API endpoints, and React components in our EHR and patient portal. Invest in platform to accelerate the rest of the team: building foundational agentic infra for others to build on top of, telemetry abstractions, realtime durability primitives, etc. On any given week you might be building an AI-powered clinical note editor, refactoring a Stripe billing flow, LoRA post-training on an open source model for clinical workflows, or digging into data to see where patients are dropping off in the intake funnel.

We build AI features that have to be reliable in production. That means structured outputs, evaluation loops, monitoring, human-in-the-loop review, and safe fallbacks. You will help turn LLM capabilities into tools clinicians actually want to use

Requirements:

• Staff-level full stack experience building and operating production systems
• Strong TypeScript skills across frontend and backend
• Expert relational database fundamentals: schema design, migrations, query performance
• Comfort shipping iteratively: feature flags, instrumentation, and tight feedback loops
• You care about code quality because you take pride in your craft
• You can drive outcomes. You have the ability to take an ambiguous problem, break it down into workstreams, manage and execute
• You have worked on agent systems. Designing evals, data-labeling techniques, self-improving agent loops
• You have built with AI/LLM APIs and understand what it takes to make them reliable in production
• experience in startups, healthcare, regulated industries, complex domain modeling, or multi-tenant systems