Full Stack Engineer

**About Skybound Therapy** We’re a small, pre\-launch, mission\-driven team focused on improving outcomes for children with autism. Many of the families we serve are supported through Medicaid. We are building a custom EHR that powers real\-world care — tools used daily by clinicians, therapists, and care teams, as well as the families themselves. Our work sits at the intersection of healthcare delivery and software. We move quickly, prioritize reliability, and believe thoughtful systems can meaningfully improve care quality and access. You’ll be joining a tight\-knit team working across engineering, product, clinicians, and leadership to build and scale systems that directly impact patient care. **What You’ll Work On** ----------------------- * Cross\-platform applications using React Native \+ React Native Web * Backend services in Node.js deployed to Google Cloud Run * MongoDB data modeling and querying * Deep AI integrations to support clinical workflows, automation, and decision support * Internal tooling and dashboards for care delivery and operations * Open source tooling we maintain and contribute to **How We Work (Our Values in Action)** -------------------------------------- * Uptime Matters * + Our software directly impacts care delivery. Systems must be reliable, observable, and resilient. Failures should be rare and recoverable. * Open Source What We Can * + We contribute back where possible. Non\-core tooling is open by default. * Release Early, Release Often * + Engineers own what they ship end\-to\-end. Fast iteration with strong monitoring and accountability. * Focus on What Matters * + We prioritize building what differentiates us and leverage best\-in\-class tools for everything else. * No Silos * + Engineers work across frontend, backend, and infrastructure. Ownership is full\-stack and end\-to\-end. **What We’re Looking For** -------------------------- * 5\+ years of experience building production software full stack (preferably TypeScript/JavaScript) * Strong experience with React * Experience with React Native (mobile \+ web strongly preferred) * Solid backend experience (Node.js preferred) * Experience with Claude Code and any AI powered IDEs * Experience with MongoDB or other NoSQL databases * Familiarity with CI/CD, observability, and cloud environments (GCP preferred) * Strong ability to work independently and cross\-functionally ### **AI Expectations (Important)** * High proficiency using AI\-assisted development tools (e.g., Claude Code, Cursor, or similar AI IDEs) * Demonstrated ability to use AI to accelerate development, debugging, and system design. Heavy use of implementation planning and tight feedback loops * Comfort integrating AI capabilities into production systems ### **Bonus** * Experience in healthcare, especially Medicaid or autism services * Experience contributing to or maintaining open source projects **How We Work** --------------- * Remote\-first (U.S.\-based team) * Low\-meeting, high\-trust environment * Clear ownership with strong collaboration * Async\-friendly but not async\-only * Emphasis on thoughtful, low\-ego teammates **Perks** --------- * Competitive salary * Strong health insurance * 20 days PTO \+ 9 sick days * Flexible working style * Large AI tooling and experimentation budget **How to Apply** ---------------- Send a note with links to things you’ve built (GitHub, apps, side projects, etc.) and a brief explanation of your interest in the role.