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Senior Engineering Manager, Business Systems & Tools

Nexhealth

San Francisco, California, United States (San Francisco) permanent

Posted: January 14, 2026

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Quick Summary

We are seeking a Senior Engineering Manager to join our team in San Francisco, CA, to lead the development of our business systems and tools.

Job Description

About NexHealth

Our healthcare system remains frustratingly analog. When you live in a world of one-tap car rides, instant meal delivery, and unlimited streaming, why do you still have to call to schedule a doctor’s appointment and fill out a clipboard in the waiting room?

NexHealth’s mission is to accelerate innovation in healthcare by connecting patients, providers, and developers. We’re building the infrastructure layer for modern healthcare, connecting thousands of fragmented, on-premise, and closed EHR systems into a single, modern platform that powers software, APIs, payments, and patient experiences across the ecosystem.

• Founded: 2017

• Headquarters: San Francisco, CA

• Funding: $177M Series C

• Employees: 200+

• Trusted by tens of thousands of providers and hundreds of health-tech developers — forging the infrastructure layer that modern healthcare needs

About the Role

You’ll build and lead our Business Systems engineering team - a core pillar that links Product, Engineering, Sales, Customer Success, and Support. This team powers seamless experiences for our 190 employees and over 14,000 provider practices by owning our BackOffice Rails app, Salesforce CRM, Intercom support platform, and our middleware. Success means recruiting and mentoring top engineers, fully automating the customer journey from first-touch through continued support, and surfacing real-time insights that enable every team to move faster and smarter.

What You’ll Do

• Lead and grow your team. Recruit and hire top-tier talent. Set the technical bar for the team and hold them accountable.

• Technical and systems ownership. Drive and review the systems architecture and code solutions. Scale our middleware solutions to enable systems expansion.

• Deliver cross-systems initiatives. Automate our GTM motions to manual onboarding, billing and handoffs. Partner with Product, CS, and Sales to translate needs into robust solutions.

What You’ll Bring

• 8+ years of experience as a software engineer, with 2+ years managing or technically leading small teams.

• Proven track record of hiring and coaching senior engineers

• Deep experience in integrating SaaS Platforms (Salesforce, Hubspot, Intercom, Stripe) into custom apps

• Expert in large scale production applications and their supporting technologies (we use Ruby on Rails, Sidekiq, PostgreSql (RDS/Aurora), AWS cloud infrastructure)

• Strong systems thinker that thrives in ambiguous high-leverage projects.

• A vision for what great software and great engineering looks like, and the technical expertise and leadership skills to make that vision a reality.

• Excellent written and verbal communication skills. You can communicate technical concepts to business stakeholders, engineering, and our GTM teams.

Compensation

Actual salaries will vary depending on factors including but not limited to location, experience, and performance. The range listed is just the base salary component of NexHealth’s total compensation package for employees. Other benefits may include stock options, an unlimited paid time off policy, and up to 100% coverage on medical, vision and dental insurance.

NexHealth Compensation Range
$187,000—$268,000 USD

Benefits

• Full Medical, Dental, and Vision (up to 100% covered)

• 401K and commuter benefits

• Flexible PTO

• High-impact work that directly improves the healthcare experience for millions

Our Values

• Solve the customer’s problems, not yours
When making decisions, think from the perspective of the customer. It’s easy to make decisions that make our lives simpler, but not the customers.

• Do the things others are not willing to do
As a Nexer, always go after the hardest problems. Pursue things at the highest quality. Move at the fastest pace.

• Take ownership
Act like a founder. Own your roles, destinies, mistakes, behavior, and our mission. The buck stops with each of us - no blaming or excuses.

• Say what’s on your mind, with positive intent
Be direct, proactive, transparent, and frequent in your communication.

• Default trust
As a Nexer, you do not have to earn trust, trust is given to you by default. If we by default trust each other, our speed of communication, feedback, information sharing, and overall improvements will be a lot faster.

• Think in first principles
We first identify the problem and then break it down to its fundamentals before diving into solutions. We constantly ask “why” to validate our assumptions.

We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, sex, gender expression, sexual orientation, age, marital status, veteran status, or disability status. We provide reasonable accommodation for individuals with disabilities to participate in the application or interview process. Contact [email protected] to request assistance.

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