Senior Product Engineer

Garner Health

Location: United States
Job Type: full-time
Salary: $182,000 - $224,000
Posted: September 26, 2025

Job Description

Healthcare quality is declining and soaring costs are crushing American families and businesses. At Garner, we’ve developed a revolutionary approach to evaluating doctor performance and a unique incentive model that's reshaping the healthcare economy to ensure everyone can afford high quality care. By providing organizations relief from surging healthcare costs, we've experienced rapid adoption in the market and have more than doubled our revenue annually over the last 5 years, becoming the fastest growing company in our space. To support our continued growth, we're expanding our team by over 50% each year, seeking exceptional talent to shape our unique, award winning culture (for example, USA Today Top Workplaces 2025) designed to cultivate teamwork, trust, autonomy, exceptional results, and individual growth that creates an inflection point in your career.

About the role:

We are looking for a Senior Software Engineer to join our team and help us develop the core systems powering the commercial and reporting side of our business. You will work closely with a talented product and design team, stay up-to-date with the latest technologies, and contribute to a fast-paced, innovative environment. The ideal candidate for this role should be able to deliver across the tech stack and is eager to learn and apply new techniques and technologies.You will be responsible for leading projects and building tools end-to-end to enable our commercial teams achieve our revenue goals and scale operations.

Where you will work:

This role will be based in our New York City office. You must be willing to work in the office 3 days per week on Tuesday, Wednesday and Thursday.

What you will do:

Design and build extensible systems that can grow with business needs
Collaborate across disciplines to understand our domain and iterate on projects
Lead technical strategy and decision-making
Protect our users’ privacy and security through secure coding practices

What you will bring to the team:

4+ years hands-on work delivering enterprise software solutions
Expertise in TypeScript, Python or modern JavaScript
Excellent communication skills and ability to clearly communicate design rationale and concepts
Strong understanding of SQL and data modeling
Experience with one or more database systems, especially PostgreSQL or ElasticSearch
Familiarity with data ecosystems - DBT, Snowflake, Python
Familiarity with React, NodeJS, Docker, and a major cloud provider

Please note: we are unable to sponsor or take over sponsorship of an employment visa at this time.

Technologies we use:

Python, TypeScript, React, NodeJS, Kubernetes, Istio, Postgres, ElasticSearch, NATS, AWS, Terraform

Compensation Transparency:

The target salary range for this position is $182,000 - $224,000. Individual compensation for this role will depend on various factors, including qualifications, skills, and applicable laws. In addition to base compensation, this role is eligible to participate in our equity incentive and competitive benefits plans, including but not limited to: flexible PTO, Medical/Dental/Vision plan options, 401(k), Teladoc Health and more.

Equal Employment Opportunity:

Garner Health is proud to be an Equal Employment Opportunity employer and values diversity in the workplace. We do not discriminate based upon race, religion, color, national origin, sex (including pregnancy, childbirth, reproductive health decisions, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, genetic information, political views or activity, or other applicable legally protected characteristics.

🎯 Who is this job for?

This role is ideal for a Senior Full-Stack Engineer with 4+ years of experience in building enterprise software using TypeScript, Python, and SQL. Strong skills in system design, data modeling, and technologies like React, PostgreSQL, and AWS are essential. Candidates should be comfortable leading projects, collaborating cross-functionally, and working onsite 3 days a week in NYC.

💬 Potential Interview Questions

How would you design an extensible reporting system across services?
Use an event-driven architecture (NATS subjects per domain) to emit normalized events, write OLTP data to PostgreSQL, and stream CDC to Snowflake where dbt builds dimensional models; keep consumers idempotent and version event schemas.
When do you choose PostgreSQL vs Elasticsearch?
PostgreSQL for transactional integrity, joins, and strong consistency; Elasticsearch for relevance-ranked search, aggregations, and exploratory queries at scale. Keep ES as a read-optimized projection via CDC or write-through.
How do you make a write endpoint in Node.js idempotent and race-safe?
Accept an Idempotency-Key, wrap writes in a transaction, and enforce uniqueness with a key table or UPSERT + unique constraints; return the stored result on retries.
What PostgreSQL indexing/optimization tactics do you rely on?
Create composite/covering indexes aligned with WHERE and ORDER BY, use partial indexes for sparse predicates, and validate with EXPLAIN ANALYZE; monitor bloat/VACUUM and keep transactions short.
How would you model sensitive healthcare data to protect privacy?
Separate PII from clinical/usage data with surrogate keys, apply column-level encryption (KMS-managed keys), minimize data via purpose-limited schemas, and enforce least-privilege roles with audited access.
How do you build a React dashboard that stays fast on large datasets?
Use React Query for server state, virtualize tables/charts, memoize selectors, and offload heavy transforms to Web Workers; stream or paginate data instead of loading all at once.
Describe a dbt/Snowflake pipeline for commercial analytics.
Ingest raw events, build incremental staging + marts with dbt models/tests, snapshot slowly changing dimensions, and document contracts; orchestrate with dependency-aware runs and freshness checks.
What does a zero-downtime, observable K8s deployment look like?
Container images with proper probes and resource requests, progressive delivery (canary/blue-green) via Istio, mTLS between services, and OpenTelemetry traces/metrics/logs tied to SLO-based alerts.
How would you use NATS (JetStream) for reliable processing?
Publish domain events to subjects with durable consumers, enable at-least-once with ack/retry and backoff, use message deduplication keys, and design handlers to be idempotent and replay-safe.
What’s your approach to Terraform for multi-environment infra?
Module-ize resources, pin provider versions, keep env-specific variables in workspaces, and run plan/apply in CI with policy-as-code (e.g., Sentinel/Open Policy Agent); store state remotely with locking.

📋 Job Summary

Garner Health is hiring a Senior Product Engineer in NYC to lead development of systems powering its fast-growing healthcare cost optimization platform. You'll build end-to-end tools using TypeScript, Python, React, NodeJS, and Postgres to support commercial operations and reporting. The role is hybrid (3 days/week in-office), offers $182K–$224K salary plus equity, and focuses on scalable architecture, secure coding, and cross-functional collaboration. Join a mission-driven team reshaping access to high-quality, affordable healthcare.