Infrastructure Engineer

San Francisco, CA
At Karuna Health, we give every patient a guide in the healthcare system. Personal care integrates naturally into every aspect of our organization. We are building a mission-focused, inclusive, and motivated team to scale a quality patient experience.

Karuna’s web app allows vulnerable, high-risk patients to build a stronger relationship with their care teams on the same messaging platforms they use with their friends and family. We build automation tools to help increase the volume and quality of interactions, measure care team performance, and eliminate back-office annoyances. All of this requires building a set of rock-solid infrastructure and APIs, and scaling it to hundreds of thousands of patients.

We focus on care management, a niche part of the healthcare ecosystem serving the most vulnerable and sickest members of our communities. Karuna engineers aim to enable healthcare organizations to build deeper, more impactful relationships with every patient, expanding the scope and accessibility of their services for all.

As an infrastructure engineer at Karuna, you will develop and launch cutting-edge tools that will transform healthcare and positively impact the lives of patients at a massive scale. From powering our core platform to solidifying a trustworthy user experience, you can shape the future of healthcare with every line of code you ship.


    • Scaling and adding stability to a Rails/Postgres microservice architecture
    • Comfortable with a modern dev-ops stack
    • Building and maintaining internal developer velocity tooling
    • Defining and developing strong testing and QA practices
    • Contributing where necessary to backend feature development
    • Collaborating with engineering team (CTO + 3 full-stack engineers) to plan and allocate capacity with stability and scaling of infrastructure in mind
    • Triage, diagnose, and solve application performance woes
    • Work with our EMR (Electronic Medical Record) integration partners to build smooth data flows in and out of Karuna
    • Do all this while maintaining and enhancing developer satisfaction and joy!

Required Skills

    • 3+ years of full-stack engineering and/or devops experience
    • Of these 3+ years, 2+ in and around Rails
    • Intimate familiarity with modern Ruby
    • Experience setting up a modern, customized devops stack from scratch
    • Eager to spend time on stability, reliability, and scaling on the backend
    • Able to independently create value around infrastructure, tooling, QA, and devops
    • Excited to help open-source relevant parts of our codebase!

Skills We'd Like to See

    • Knowledge of configuration management systems such as Puppet, Chef, Salt, or Ansible
    • Strong knowledge of Software Engineering and Computer Science fundamentals. It usually comes with Bachelors in CS, but doesn’t have to be.
    • 1+ years experience at an early-stage startup
    • Experience with large scale, high-volume, production-quality messaging architecture
    • Experience with Electronic Health Record (EHR/EMR) integration
    • Demonstrated passion for healthcare and social impact

Who You Are

    • Excitement for infrastructure and devops. This is your craft.
    • Actively choose progress over perfection.
    • Possess a strong bias towards getting it done. You take initiative and don’t need to wait for permission.
    • Deeply mission driven and motivated by empowering patients when they feel helpless, anonymous, and alone.
    • Comfortable with, embrace, and thrive in uncertainty.
    • Able to build reliable and sustainable systems with limited resources.

Why You Should Join Us

    • Be on the ground floor of a rapidly growing company.
    • Work with a Rails contributor, a skilled DevOps Engineer, and accomplished React developers.
    • Have the autonomy to build something with a brilliant and enthusiastically supportive team.
    • Learn best practices from world class investors and advisors including First Round Capital, Founder Collective, SV Angel, and BoxGroup.
    • Shape the culture of engineering at Karuna.
Karuna Health is proud to be an equal opportunity employer. We are committed to building a diverse and inclusive culture and celebrate authenticity. We do not discriminate on the basis of race, religion, color, national origin, gender, gender identity, sexual orientation, age, marital status, disability, protected veteran status, or any other legally protected characteristics.