Pelairo Inc. | Senior Full Stack Developer | REMOTE (US Only) | Full-time | $100-150k
At Pelairo we're building the most intuitive and flexible Laboratory Information Management System (LIMS) on the market. "Manage the lab, not the LIMS!"
After a successful hire from our post in November, we're back! We're looking for a hands-on Senior Full Stack Developer to help design and deliver core product experiences across our stack (TypeScript + NestJS on the backend and Next.js on the frontend.) You'll work on customer-facing workflows, turning ambiguity into shippable slices, and helping us level up reliability, security, and speed as we scale.
What you'll do:
- Build features: implement and ship production ready functionality across frontend and backend (TypeScript, Next.js, NestJS).
- Backend: contribute heavily to APIs, data models, and integrations that power questionnaire-driven workflows and FHIR pipelines.
- Frontend: build intuitive, configurable UI modules for complex healthcare workflows, collaborate closely with Product and domain experts.
- Quality & reliability: contribute to testing strategy (unit/integration/contract/E2E), safe migrations, and rollouts (feature flags).
- Observability & performance: instrument tracing/metrics/logging, improve dashboards/alerts, and participate in incident reviews and follow-ups.
- Engineering excellence: raise the bar through strong code reviews, pragmatic standards, and improvements to the developer experience.
- FHIR correctness: help ensure backend transformations produce valid FHIR resources in Medplum and support scalable data flows.
What makes you a great fit:
- 7+ years building production web applications (frontend + backend) in a fast-moving environment.
- Strong TypeScript + Node.js experience and solid production exposure to NestJS (or comparable backend frameworks with willingness to ramp quickly).
- Strong experience with modern React-based frontend development (React / Next.js) and comfort owning UI implementation details.
- Experience shipping ambiguous projects end-to-end with good judgment, pragmatism, and clear communication.
- Familiar with building secure systems and thoughtful about reliability, testing, and performance.
Bonuses:
- Experience with FHIR / Medplum, healthcare data workflows, or LIMS/clinical systems.
- Familiarity with HIPAA and/or SOC 2 practices.
- AWS experience (e.g., Cognito, Fargate) and comfort working in cloud-native environments.
Stack: TypeScript (Next.js + NestJS), Medplum, AWS (Cognito, Fargate)
Visa/relocation: No
How to apply: Email hiring [@] pelairo.com and mention "HN Who's Hiring January 2026." (We know our website needs some work, but the product is our priority right now.)