156. Senior Full Stack Developer (Python / React)

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.

Responsibilities

• 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.
• 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

Requirements

• 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.

Benefits

Additional Information

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.

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