SlipstreamJobs tracks this role from the company's public career site. Apply directly on the employer's site.
Flagler Health is building a clinical operating system for modern musculoskeletal care. The company partners with MSK provider groups and specialty clinics to help them grow, operate efficiently, and deliver better longitudinal care. Recently raised Series B funding, Flagler is entering its next growth phase.
As a Senior Fullstack Engineer, you will own the main product surface end-to-end. The tech stack is Vue 3 and TypeScript on the frontend, Express and MongoDB on the backend, with shared TypeScript packages throughout. You'll move across the full stack rather than specializing on one side.
The core challenges are not algorithmic but domain-specific: clinical data is messy (same patient spelled multiple ways, dates with different meanings across systems), and human behavior is unpredictable (rescheduling, no-shows, incomplete information). The role requires engineers who find this interesting and want to model reality rather than oversimplify it.
The work is contract-first: API schemas are declared once and both frontend and backend typecheck against them, making broken endpoints build failures instead of bug reports.
Key responsibilities include building screens against the internal component library, designing and implementing API routes with shared schemas, modeling clinical and revenue cycle data in MongoDB at scale, working in shared TypeScript packages, taking features from spec to production, supporting live features, working across the full revenue cycle (pre-visit clearance through payment), and integrating with EHRs and external systems.
Required: 5+ years shipping production web applications, 3+ years healthcare revenue cycle management experience, strong TypeScript across the stack, modern frontend framework experience (Vue or React), Node/Express/MongoDB backend experience, understanding of query performance and indexing, experience with health data integration (HL7, FHIR, EHR connectivity), complex auditable systems design, and financial transaction state management.
Preferred: understanding of clinical workflows and care delivery, OpenAI API or LLM experience, monorepo experience, realtime/streaming applications, durable workflow orchestration, cloud platform experience, analytics/reporting on transactional data, and EDI/X12 experience.
Hybrid role based in NYC with regular on-site presence required. Distributed team with offices in NYC and Vancouver.
