As a Senior Full Stack Engineer on the Care Team, you will join a team that is working to improve patients’ lives through a better pharmacy experience. The Care Team owns the services that manage all of prescription processing from intake up to the moment we send an order to our pharmacies for fulfillment. The key focus areas for the Care Team include:
Preparing prescriptions for fulfillment and delivery as quickly and accurately as possible through a combination of automation and efficient manual task coordination when third party input is required to advance a fill
Enabling the growth of the business by enabling partners like drug manufacturers, insurers, and individual providers to easily configure billing, benefits, and clinical workflows tailored to their use cases

Job Description

Example Projects:

Increase Alto’s intake automation rate by leveraging LLMs to parse unstructured data from prescriptions

Accelerate pharmacist workflows by integrating controlled substance dispensing history and risk scores into our pre-dispense clinical safety and review step

Optimize the selection of which drug to dispense to find patients the best price

Accelerate Your Career as You

• Excited about balancing low inventory on hand with high availability

• Establish the foundations for an extensible inventory management platform to fuel business growth

• Mentor other engineers, encouraging best practices in software development and design

• Solve complex technical problems at the intersection of healthcare and e-commerce

• Thought leader on how to build world class predictive systems

A Bit About You

Minimum Qualifications:

• Bachelor's degree in Engineering or equivalent experience

• 10+ years of progressive software engineering experience in a high volume, high throughput production environment

• Background in Backend or Full Stack technologies

• Expertise in architecting complex systems for long-term maintainability, performance, and scalability

• Strong engineering fundamentals and experience building high volume, high throughput, resilient systems.

• Proven track record of technical best practices, including code style, documentation, code review, bug fixing, and production issue mitigation.

• Relentless in pursuing impact through their work.

Preferred Qualifications:

• Solid experience with supply chain optimization systems.

• Proficiency in Alto's tech stack: Rails, Python, and PostgreSQL.

• Experience building and integrating predictive ML models.

• Demonstrated ability to thrive in a dynamic entrepreneurial environment and maintain a growth mindset.

• A pragmatic approach to problem solving that’s biased towards impact.

• A strong sense of ownership over your work and a desire to uplevel your peers.

• Passion for Alto’s mission and our company values.

• Experience designing and implementing service oriented architectures.

Additional Information

Additional Physical Job Requirements

Physical requirements for this role include the ability to work at a computer terminal with monitor, keyboard and mouse for extended periods of time, periodically move away from the computer terminal for in-person meetings, stoop, bend, and reach for equipment and supplies, make frequent repetitive motions required to operate a computer that include the wrists, hands and fingers, and lift, carry, push, pull, and move objects up to 50 pounds. The role also requires the ability to effectively communicate through verbal interactions, discern auditory information, and visually perceive details to perform essential job functions.

Consistent with the Americans with Disabilities Act (ADA) and similar applicable state laws, it is Alto’s policy to provide reasonable accommodation to enable qualified individuals with disabilities to perform essential job functions, unless such accommodation would cause an undue hardship.

Salary and Benefits

Salary Range: $172,000 - $215,000

Commission Eligible: No

Travel: No - Required up to 0% of the time

Location Requirement: Employment at Alto is limited to individuals residing in the following states: Arizona, Arkansas, California, Colorado, Florida, Kansas, Maryland, Missouri, Nevada, New Jersey, New York, North Carolina, Oregon, Pennsylvania, South Carolina, Tennessee, Texas, Washington (WA), and Wisconsin.

Employment Authorization Requirement: Applicants must be authorized to work for any employer in the U.S. At this time, Alto is unable to sponsor or take over sponsorship of an employment Visa.

Benefits: Full-time employee benefits include: dental, vision, and multiple group medical plans to choose from, a 401(k) retirement savings plan, group life insurance, accidental death and dismemberment (AD&D) insurance, flexible spending account (FSA) and health savings account (HSA), commuter benefits, employer-paid short-term (STD) and long-term disability (LTD) insurance, and additional supplemental insurance plans (spouse life insurance, legal insurance, an employee assistance program, and a fertility medication discount program). Employees are also provided flexible vacation time, accrued paid sick time, 11 paid holidays (seven for Pharmacy and Care team members), and eight weeks of paid parental leave for eligible employees.

More Benefits Information Here: https://west.acrisure.com/alto-pharmacy/benefits/

Application deadline: September 27, 2025

#LI-Remote

Alto Pharmacy is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, religion, sex, gender identity, sexual orientation, age, disability, veteran status, or any other legally protected basis. If you have a disability and require reasonable accommodation during any portion of the application or hiring process, please contact us at CandidateHelp@alto.com.

Alto Pharmacy considers qualified applicants with arrest or conviction records for employment and conducts background checks consistent with applicable law, including the California, Los Angeles County, San Francisco, and New York City Fair Chance laws. We are an E-Verify participating company.

Alto Pharmacy recruiters and hiring managers may use automated decision-making tools to assist with identifying candidates who match the stated job requirements, and to what extent. These tools are designed to help ensure fairness in all aspects of the hiring process by providing recruiters and hiring managers with data-backed insights based on information provided in your resume, including work experience, education, and other skills. If you have any questions or would like to request an alternative process, please contact us at CandidateHelp@alto.com. To learn about Alto Pharmacy's privacy practices including compliance with applicable privacy laws, please click here.