About Prax Health

The US is in an access to care crisis. One in four people lack access to essential primary care.

NPs and PAs are stepping in to fill that gap. They deliver essential care, and due to changing regulations, are setting up independent practices to serve their communities. However, starting and running an independent practice has been a bureaucratic nightmare. Until now.

Prax Health is the all-in-one platform for nurse practitioners and physician assistants launching independent practices. We handle everything from legal practice formation, to website setup, to insurance credentialing, to billing and revenue cycle, to the EHR, so providers can focus on patients.

We are a seed-stage company with real revenue from real providers and real patients, and we’re growing fast. The engineering team is small, senior, and ships constantly.

About the Role

We need a full-stack Rails engineer to work on the core Prax platform. The stack is a monorepo: Rails API backend, multiple Next.js frontends (eg, provider dashboard, patient portal, marketing site), and a growing AI agent layer built on the Claude Agent SDK. Postgres, Solid Queue for background jobs, React/Next.js with Tailwind on the frontend.

This is a production application serving real customers today. You will own features end to end. One week you're building an insurance eligibility flow, the next you're integrating a new payer API or improving internal operations tools.

What You Will Work On

Provider-facing features: onboarding workflows, credentialing, practice management dashboards
Insurance and billing integrations (payer APIs, eligibility checks, claims processing)
Internal operations tools for the Prax clinical and ops teams
AI agent infrastructure and tooling (we use Claude extensively, including as a product feature)
Background jobs, data pipelines, and third-party service integrations
Infrastructure and deployment on Render

What We Are Looking For

Strong Ruby on Rails experience (3+ years in production applications)
Comfortable with React/Next.js and TypeScript on the frontend
Pragmatic about shipping. We'd rather have it working in production than perfectly abstracted in a PR.
Experience with Postgres, background jobs, and API integrations
Effective with AI-assisted development tools (Claude Code, Cursor, or similar). We expect engineers to use agentic coding tools daily and to be thoughtful about when and how to use them.
Good instincts for code organization, testing, and maintainability
Can work independently and communicate clearly in a remote, async-first team

Nice to Have

Healthcare or regulated-industry experience
Experience with Stripe, HubSpot, or PostHog integrations
Familiarity with monorepo tooling (Turborepo, pnpm workspaces)
Comfort with infrastructure (Docker, CI/CD, Pulumi)

Our Hiring Process

We don't do whiteboard interviews. Our process:

Short intro conversation with Nick (CTO/co-founder)
Practical take-home Rails challenge (~90 minutes, reflects real Prax work)
Team conversations (CEO + engineering team)
Offer

Compensation

Competitive compensation. Equity (stock options). Health benefits. Remote-first, flexible schedule.

Apply

Send your resume and a note about what interests you to [email protected]. Include a link to your GitHub or any recent work you're proud of.