156. Senior Full Stack Developer (Python / React)

We’re looking for a Senior Full Stack Developer (Python - React) to join Source Meridian.

About Source Meridian

Source Meridian is a development software company that works to solve the industry’s most challenging problems in healthcare practices. We are laser focused on specific technologies in the healthcare and life science industries: Healthcare technology, artificial intelligence, and healthcare interoperability.

About the Role

You are the builder. You work directly alongside the domain experts, co-write the most critical and risk-sensitive modules, build the test infrastructure, and handle the complex backend work that requires deep engineering skill — not just domain knowledge and an AI prompt. You also serve as the second PR reviewer, taking load off the Tech Lead for lower-risk PRs so the review queue doesn't become a bottleneck.

What You’ll Do

• Co-build the platform scaffold: PostgreSQL schema (core entities, tenant-scoped tables, RLS policies), FastAPI project structure, Entra ID auth integration, Azure Service Bus queue setup.
• Implement the TenantScopedModel base class and write the first RLS test battery.
• Load and validate the CMS MPFS fee schedule (ETL pipeline from CMS fixed-width files into PostgreSQL).
• Set up the local development environment (Docker Compose: PostgreSQL, Redis, Service Bus emulator) and document it.
• Repricing engine. Write the Medicare RVU calculation core (hlh-repricing-core package). This is the single most sensitive component in the platform — pure deterministic function, zero external dependencies, unit tests for each of the five calculation steps independently. This is not AI-generated. You write this by hand.
• Tenant isolation layer: Implement and test the dual-control pattern (application-layer TenantScopedModel + PostgreSQL RLS with set_config on connection checkout/checkin). Write the cross-tenant test battery that runs in CI on every PR.
• State machine transitions: Implement the custom state machine (14 states, WorkflowTask table, SLA polling job).
• Service Bus workers: Build the worker infrastructure (OCR jobs, packet generation, sync adapters). Ensure idempotency, dead-letter handling, and forward-compatible message schemas for rolling deployments.
• PHI automated controls: Implement the CI/CD PHI pattern scanner, the runtime outbound payload filter for LLM API calls, and the continuous log monitoring queries.
• Review PRs that the Tech Lead delegates: UI components, Service Bus worker handlers, non-financial data pipeline code, Dynamics sync adapters.
• You review for: module boundary compliance, idempotency, error handling, and test coverage. The Tech Lead retains final authority on financial logic and tenant isolation PRs.

Required Qualifications

• Python 3.12+ / FastAPI
• PostgreSQL — advanced. RLS policies, SQLAlchemy 2.0 async, Alembic migrations, JSONB with GIN indexing, connection pool lifecycle management.
• Azure Service Bus — message handling, dead-letter queues, retry with exponential backoff, idempotent consumer patterns.
• Test-driven development
• Azure — Container Apps, Blob Storage (pre-signed URLs, lifecycle policies), Key Vault, Application Insights structured logging.
• React — solid working knowledge.
• AI-assisted code review.
• CI/CD pipeline engineering — Azure DevOps Pipelines.
• English B2+ - C1

Nice to Have

• Healthcare domain experience or HIPAA-regulated environment experience.
• Anthropic Claude API integration (structured JSON extraction, prompt engineering for schema-conformant output).
• Azure Form Recognizer / Document Intelligence experience.
• Experience with financial calculation engines (fee schedules, pricing models, audit trail requirements).

Soft Skills.

• Proven client-facing experience.
• Excellent communication skills.
• Strong expectation management abilities.
• Strategic mindset with a solution-oriented approach and strong decision-making skills.

What We Offer

✔ Permanent contract
✔ Learning and continuous growth environment
✔ Benefits package focused on health and well-being
✔ Competitive salary based on experience

📍 Apply only if you reside in Colombia or Ecuador

At Source Meridian, you’ll be part of a high-impact tech-health company, building products that truly make a difference.

If you meet the profile — or know someone who might be interested — apply now!

We’d love to meet you 💬