Senior Software Engineer, DevOps and Infrastructure

About the role

Axle Health builds AI scheduling and workforce management software to empower in-home healthcare providers to deliver exceptional, personalized care right where patients feel most comfortable-at home. Some of the biggest providers in the country use our software (like Cityblock Health and U Penn Health System) to improve the utilization of their field teams by 17%+, and automate the operational burden of scheduling and dispatching. Our platform includes proprietary logistics algorithms to optimize scheduling, a mobile app for field staff, an operations dashboard for office teams, engagement and booking tools for patients, and a wide range of integrations and external APIs for modular access. We're a team of top-tier engineers and operators, backed by $14m from top investors such as Y Combinator, Pear VC, and F-Prime, applying our intellect and logistics experience to upend how home healthcare is delivered. About You Axle Health is building AI scheduling and workforce management software that powers in-home healthcare delivery for some of the largest providers in the country. As we scale our platform to support hundreds of thousands of patients and expand our enterprise customer base, the reliability, security, and performance of our infrastructure becomes mission-critical; not just technically, but for the patients whose care depends on it. We're looking for a Senior Engineer, DevOps & Infrastructure to own the foundation that everything else runs on. This is a high-ownership, high-impact role for someone who takes deep pride in the craft of building secure, observable, and scalable cloud infrastructure. You'll be the primary driver of our DevOps maturity, security posture, and HIPAA compliance at the infrastructure layer: working closely with our backend engineers to make sure every system we ship is reliable, hardened, and production-ready. Our ideal candidate is a seasoned infrastructure practitioner who thrives in fast-moving startup environments, brings strong security instincts, and can operate with significant autonomy while staying closely connected to the engineering team's day-to-day work.

Responsibilities

• Own and evolve Axle's cloud infrastructure on AWS, driving architectural decisions that balance security, scalability, cost, and developer velocity
• Design and maintain CI/CD pipelines with integrated security controls including code scanning, secret detection, and dependency vulnerability checks
• Lead infrastructure-as-code initiatives using Terraform or equivalent tools, maintaining clean, audited, and well-documented configurations across all environments
• Implement and enforce HIPAA-compliant security practices at the infrastructure layer - including PHI encryption, audit logging, BAA management, and access controls
• Manage container orchestration (Docker/Kubernetes), including image hardening, pod security policies, and least-privilege configurations
• Build and maintain centralized logging, monitoring, and alerting systems (e.g., Datadog) to enable proactive detection of anomalous activity and rapid incident response
• Implement and maintain secrets management using tools like AWS Secrets Manager or HashiCorp Vault, eliminating hardcoded credentials across services
• Configure and maintain network security controls including WAFs, DDoS protection, TLS certificate management, and network segmentation across environments
• Partner with engineering teams to enforce environment parity and prevent configuration drift across development, staging, and production
• Coordinate and support penetration testing engagements, remediation tracking, and patch management across servers, containers, and dependencies
• Support disaster recovery planning, backup validation, and risk assessment processes aligned with HIPAA contingency plan requirements

Requirements

• Bachelor's degree
• 7+ years of hands-on experience in DevOps, infrastructure engineering, or site reliability engineering, ideally at a growth-stage company
• Deep expertise with AWS including: IAM, VPC, ECS or EKS, RDS, S3, CloudWatch, and related HIPAA-eligible services
• Strong infrastructure-as-code experience with Terraform or CloudFormation, including security auditing of templates and managing state across environments
• Proven track record implementing security controls in CI/CD pipelines (code scanning, secret detection, SAST/DAST tooling)
• Hands-on experience with container security: Docker and Kubernetes hardening, image scanning, and runtime policy enforcement
• Working knowledge of HIPAA technical safeguards, including PHI encryption at rest and in transit, audit log requirements, and Business Associate Agreements
• Strong operational instincts: you write runbooks, you care about on-call hygiene, and you close the loop on incidents with structured postmortems
• Experience at a healthcare technology company or in another compliance-heavy industry (SOC 2, FedRAMP, PCI DSS)
• Familiarity with Datadog or similar observability pla

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