NikoHealth is a rapidly growing SaaS company transforming how Durable Medical Equipment (DME) and Home Medical Equipment (HME) providers operate. Our innovative, all-in-one platform streamlines business operations, empowering providers to work smarter and more efficiently.

About The Role

This is a newly created role, and one of the first two engineering hires NikoHealth will made in the United States. You'll report directly to the CTO and own how our software gets released and run while working closely with other senior engineers.

We operate dozens of .NET services deployed per-customer on Windows Server and IIS in AWS, managed with Terraform and Octopus Deploy. Across hundreds of provider tenants that's thousands of running application instances. Today a change waits for the next release train, and the train then takes weeks to reach the whole fleet, so end-to-end a given feature takes months. Improving our deployment and development experience is the first job. After that there are dozens of areas of platform investment needed to support how fast we're scaling.

What You'll Do

• Own our CI/CD pipeline end to end, with the authority to change what it deploys and how.
• Own developer experience. Reproducible builds, a local environment someone can actually stand up, and fast honest feedback on every change. This is half the job, not a side effect of the other half.
• Get our automated regression suite running in CI. It exists, it's substantial, and it isn't currently executed.
• Cut release lead time and get the fleet inside a published, committed release window.
• Make fleet version state answerable by a query instead of by a person, so anyone can see what a customer is running.
• Design and publish an access model, so provisioning stops routing through one inbox.
• Start bringing runtimes and dependencies current, beginning with the shared libraries everything else depends on.
• Document and share what you learn, so infrastructure knowledge stops being concentrated in one place.

What You'll Bring

• 5+ years in platform, infrastructure, or DevOps engineering.
• Production Terraform, including state you owned and drift you had to reconcile.
• Production Windows Server and IIS, application pools included.
• End-to-end ownership of a CI/CD pipeline in a previous role.
• AWS at the level this estate uses it: EC2, ALB, VPC, IAM.
• A track record of replacing a manual process with a measured and automated one, where you can tell us the before and after.
• Evidence you've made other engineers faster, not just the systems. Build times, local setup, test feedback, whatever it was.
• Daily working use of AI coding agents such as Cursor or Claude Code, including the harness around them: tests, project instructions, and a loop you can run again.

Nice to have

• Octopus Deploy, or another deployment orchestrator you owned.
• Single-tenant or multi-tenant SaaS at meaningful scale.
• Healthcare, HIPAA, or another regulated environment.

How we work

This is brownfield and we're honest about it. Some of this estate is well-built and some of it grew. We're not asking you to rewrite it, because hundreds of providers bill claims through it every day. We're asking you to make it measurable, make it safe to change, then change it. If you've built a career inheriting other people's systems and making them boring, you'll like it here.

We work with AI agents, seriously. The team works agentically and so will you. What matters is what you do after the agent produces something: tests, linters, project instructions, a loop you can run again. If your answer to a bad result is a longer prompt, we're probably not a fit. This is also why developer experience sits in this role rather than somewhere else: an agent is only as good as the feedback loop it runs in, and ours needs work.

Most application development is done by a long-standing engineering partner. You'd own the pipeline, the infrastructure, and the environments, and over time the standards their code meets before it ships while working closely with our off-shore development team.

Two people isn't a platform team, it's the start of one. Until it's three, coverage is shared between you, the CTO, and our head of engineering. Everyone here is remote, and we'd like your hours to overlap the US East Coast.

This is the start of the engineering team, not the end of it. We're hiring more engineers through 2027. The people who join first get the widest scope, the most say in how the team gets built, and first choice about what they own as it grows.

How to apply

Apply through the link on this page. Instead of a cover letter, we ask one question: tell us about a system you inherited, and the first thing you measured. A few sentences is plenty.

Use AI to help write your application if you want to, we do too. We read every one ourselves, and we can tell when nobody read the posting.

Your first conversation will be with our CTO, who is the hiring manager and will walk you through the rest of the process.

Compensation and benefits

• The range shown for this role is base salary, and does not include equity or bonus. We post it because we expect to pay inside it.
• Equity in the company.
• Medical / dental / vision, 401(k) - up to 4% matching, Unlimited PTO policy

This is a remote role, but candidates must be based in the U.S.