Sr. Platform Engineer (Infra Pod)

About this role

About Pair Team

Pair Team is building a new kind of healthcare system across Medicaid, Medicare, and public assistance programs: one that recognizes that access to housing, nutritious food, and reliable transportation are just as critical to health as having the right medications or seeing a doctor.

As a public benefit corporation and AI-enabled medical group, we partner with shelters, food pantries, and community organizations to deliver “whole-person” care to the 115 million Americans who rely on the safety net. We are currently the largest complex care provider in California with over 500 employees and are expanding nationally. Our model replaces fragmented healthcare and social services systems with one trusted relationship for all medical, behavioral, and social needs. We improve access, build trust, and dramatically lower costs (52% fewer ER visits, 26% fewer hospitalizations). Our model is a rare combination of saving tax payer dollars ($150B annually at scale) while putting people on an upward life trajectory. At national scale, this approach would save taxpayers.

These outcomes are driven by the AI-first, whole-person infrastructure we are building — a platform that connects healthcare and social-service organizations into a unified network. Leveraging our vast data and years of operational experience, we are building the agentic infrastructure for the safety net to coordinate care, automate operations, and learn from every patient interaction to continuously improve outcomes.

Read more about the AI-First Medicaid System we are building here .

• Forbes: For Pair Team, Accessibility Is About Delivering Healthcare To Those Who Need It The Most

• TechCrunch: Building for Medicaid’s regulatory moment with Neil Batlivala from Pair Team

• Journal of General Internal Medicine: A Novel Intervention for Medicaid Beneficiaries with Complex Needs

• Pair Team Accepted into CMS ACCESS Model to Expand AI-Enabled Care for Medicare Beneficiaries

About the Opportunity

We’re hiring a Senior Platform Engineer to build the infrastructure and shared engineering capabilities that will enable Pair Team to scale. This role will own foundational systems and patterns that make it easier for product and engineering teams to build, deploy, integrate, and operate services safely and independently.

You’ll work at the intersection of cloud infrastructure and application engineering to create the core services and capabilities that teams across Pair Team depend on. This is a highly leveraged role: rather than building for one product team, you’ll build the platform that enables every product team to move faster.

The ideal candidate brings a deep expertise in AWS and Terraform while also being comfortable working in our Ruby on Rails codebase.

This is a fully remote position reporting up to the Engineering Manager.

What You’ll Do

• Own the shared platform layer across the systems we operate, including our Patient Care Application, AWS, Vendor Integrations, , Postgres, Snowflake, Github, CI/CD, and other critical systems.

• Establish reusable patterns and conventions so engineers can interact with unfamiliar infrastructure consistently and confidently.

• Design and improve cloud infrastructure with a focus on scalability, reliability, security, and developer experience.

• Build core application services in Ruby on Rails, including foundational capabilities around authorization/RBAC, jobs and queues, deployments, and integrations.

• Own foundational infrastructure and services that sit beneath our product teams, including platform, IAM, HIE, EMR, and integration layers.

• Improve developer experience and engineering velocity by identifying infrastructure bottlenecks and turning manual processes into reliable, self-service workflows.

• Build for scale, ensuring our platform can support significant growth in engineering teams, products, integrations, and infrastructure without creating operational bottlenecks.

• Partner closely with product and engineering teams to understand their needs and build platform capabilities that make their work easier and faster.

• Set technical standards and architectural conventions that other engineers and teams can build upon.

• Operate production infrastructure, participating in troubleshooting and improving the reliability and resilience of critical systems.

What You’ll Need

• 5+ years of software engineering experience as a high-performing individual contributor, building and operating production backend systems

• Deep expertise in Ruby on Rails with strong understanding of both application and data layers and hands-on experience building and maintaining core backend services

• Strong relational database skills, including data modeling and query optimization: reading query plans, resolving slow queries and N+1s, and getting indexing right

• Experience building and operating platform-level capabilities such as authentication/RBAC, jobs and queues, CI/CD, deployments, integrations, and other shared services that enable engineering teams to move independently.

• Ability to work across the application and infrastructure layers—you’re an application engineer who is comfortable getting into infrastructure, or a cloud/platform engineer who is willing to work deeply in Rails.

• AWS and Terraform experience are a plus, but not required.

• Proven experience tackling the hard parts of production engineering, such as major Rails upgrades, significant database migrations, zero-downtime schema changes, large-scale data backfills, dependency upgrades, and security remediation.

• A track record of keeping a production codebase current on its dependency and package upgrades, treating that maintenance as steady, ongoing work

• Strong systems thinking and technical judgment, with the ability to establish reusable patterns, conventions, and abstractions that make complex systems easier for other engineers to understand and operate.

• Builder mindset with a bias tow

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