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Principal Engineer / Tech Lead

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Pelairo Inc. | Principal Engineer / Tech Lead | REMOTE (US) | Full-time

At Pelairo we're building the most intuitive and flexible Laboratory Information Management System (LIMS) on the market. "Manage the lab, not the LIMS!"

About the Role

We're looking for a hands-on Principal Engineer to lead the design and delivery of our backend—built on TypeScript + NestJS—and help our small team iterate quickly with confidence. You'll turn ambiguity into shippable slices, help set technical direction, and raise the bar on reliability, security, and speed.

Responsibilities

  • Own the backend: spend meaningful time writing and reviewing production code.
  • Architecture stewardship: keep the system coherent as we scale questionnaire-driven workflows and FHIR pipelines.
  • Reliability & quality: Establish testing strategy (unit/integration/contract/E2E), migrations, rollouts (feature flags).
  • Observability: Instrument tracing/metrics/logging, build dashboards/alerts; drive incident reviews.
  • Raise the engineering bar: define and enforce code review policy, branching model, testing strategy, and CI/CD gates.
  • Partner with Product & domain experts: translate healthcare workflows into configurable front-end modules; ensure back-end transforms to valid FHIR in Medplum.

Requirements

  • 8+ years building production systems, including principal/staff scope in a startup or similar pace.
  • Deep TypeScript + Node.js and expert-level NestJS in production.
  • Track record leading cross-team projects and influencing architecture without heavy process.
  • Product sense and crisp communication; comfortable owning ambiguous problems and shipping quickly with guardrails.

Bonuses

  • FHIR/Medplum
  • Healthcare data workflows
  • HIPAA/SOC 2 experience
  • Comfortable jumping into modern frontend (React/Next.js) when needed.

Stack

TypeScript (Next.js and NestJS), Medplum, AWS (Cognito, Fargate)

Visa/Relocation

No

How to Apply

Email hiring [@] pelairo.com and mention "HN Who's Hiring November 2025". (We know the website needs some work, but the product is our priority right now.)

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