At Fuze Health, we put patients first and tirelessly address the most pressing needs in healthcare. We empower millions to digitally connect with care providers, essential health resources and needed treatments – and enable care providers, employers, health plans and life sciences companies to meaningfully enhance quality, outcomes and value. We are dedicated to helping our partners evolve and modernize to meet emerging patient and marketplace needs.

Fuze Health’s foundation is built upon the strategic combination of several proven, technology-powered innovators in the digital health, diagnostics, and pharmacy sectors. Our growing portfolio brings together the capabilities of industry leaders including LetsGetChecked, Truepill, and Alto Pharmacy, to create a distinctive, unified force in healthcare. Together, we have the shared vision, advanced capabilities and talented teams to deliver next-generation solutions that patients and healthcare partners need today and into the future.

About Alto / FuzeRx

Alto provides an easier, more efficient and more affordable pharmacy experience for patients, providers, and partners. Our full-service, digitally-powered pharmacy makes it simple for patients to live their healthiest life, while our technology empowers partners with automated and customizable solutions for the entire pharmacy value stream. To learn more about Alto, you can review our Founders’ Story and our Values.

We are looking for a highly skilled Full Stack Software Engineer to join our engineering team at Alto Pharmacy. At Alto the engineers are thought leaders and have a passion to build elegant software with high impact. You will work on industry disrupting platforms, on complex technical challenges that solve complex customer problems, together with your talented colleagues. This position will involve working on internal applications that serve commercial external customers, with a focus on both the backend and frontend. The ideal candidate will have experience with monolithic applications, Rails, and a strong passion for building scalable and high-performing software solutions. A background in health tech, pharmacy, or commerce technology is highly preferred.

Short Term Assignments typically last up to 6 months.

Job Description

Job Description

Accelerate Your Career as You

Design, build, and maintain scalable full-stack solutions for internal and external users.
Collaborate with product and business teams to deliver customer value.
Write clean, maintainable, and efficient code in Ruby on Rails and other modern programming languages.
Contribute to AI and machine learning initiatives and leverage them into existing platforms for better automation and prediction.
Ensure high availability, performance, and security of applications.
Troubleshoot and debug issues across high volume, high throughput, highly performant, and direct user interacting systems.
Passion for observability and operationalization, building alerting, and measuring the impact of the code you build.
Collaborate with cross-functional teams to drive innovation in software solutions.
Stay up-to-date with the latest software development trends and technologies.

Minimum Qualifications

A Bit About You

Bachelors in Computer Science or related field
Minimum of 5+ years of experience as a Full Stack Software Engineer
Experience building and deploying applications in Ruby on Rails and decoupling them into externalized services with API interfaces.
Excellent knowledge of full-stack development, including frontend (HTML, CSS, JavaScript) and backend (databases, APIs, server-side technologies. multi-tenancy, workflow orchestration and choreography. long running saga patterns)
Experience working with databases, both SQL and NoSQL.
Ability to troubleshoot and optimize both frontend and backend systems.
Strong interest in AI technologies or experience integrating AI solutions.
Passion for building scalable, efficient, and high-quality software.

Preferred Qualifications

Experience in health tech or pharmacy-related industries
Experience in supply chain or commerce technology
Familiarity with cloud services (AWS, GCP, or Azure)
Understanding of CI/CD processes and modern development workflows
Implement and maintain backend-for-front-end (BFF) architectures
Strong communication skills and ability to collaborate in a fast-paced environment

Short Term Assignments typically last up to 6 months.

Additional Information

Additional Physical Job Requirements

Physical requirements for this role include the ability to work at a computer terminal with monitor, keyboard and mouse for extended periods of time, stoop, bend, and reach for equipment and supplies, make frequent repetitive motions required to operate a computer that include the wrists, hands and fingers, and lift, carry, push, pull, and move light objects up to 20 pounds. The role also requires the ability to effectively communicate through verbal interactions, discern auditory information, and visually perceive details to perform essential job functions.

_Consistent with the Americans with Disabilities Act (ADA) and similar applicable state laws, it is Alto’s policy to provide reasonable accommodation to enable qualified individuals with disabilities to perform essential job functions, unless such accommodation would cause an undue hardship.

_Salary and Benefits

Salary Range: $124,800 - $156,000

Commission Eligible: No

Travel: No - Required up to 0% of the time

Location Requirement: Employment at Alto is limited to individuals residing in the following states: Arizona, Arkansas, California, Colorado, Florida, Kansas, Maryland, Missouri, Nevada, New Jersey, New York, North Carolina, Oregon, Pennsylvania, South Carolina, Tennessee, Texas, Washington (WA), and Wisconsin.

Employment Authorization Requirement: Applicants must be authorized to work for any employer in the U.S. At this time, Alto is unable to sponsor or take over sponsorship of an employment Visa.

Benefits: STA (Short-Term Assignment) employees are eligible for legally required benefits, including paid sick time, workers’ compensation insurance and unemployment insurance, as well as the Company’s Minimum Essential Coverage (MEC) medical plan. This plan focuses on preventive care—including annual checkups, screenings, immunizations, and prenatal care—at no cost when services are provided by an in-network provider.

Application deadline: December 15, 2025

_Alto Pharmacy is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, religion, sex, gender identity, sexual orientation, age, disability, veteran status, or any other legally protected basis. If you have a disability and require reasonable accommodation during any portion of the application or hiring process, please contact us at CandidateHelp@alto.com.

__Alto Pharmacy considers qualified applicants with arrest or conviction records for employment and conducts background checks consistent with applicable law, including the California, Los Angeles County, San Francisco, and New York City Fair Chance laws. We are an E-Verify participating company.

Alto Pharmacy recruiters and hiring managers may use automated decision-making tools to assist with identifying candidates who match the stated job requirements, and to what extent. These tools are designed to help ensure fairness in all aspects of the hiring process by providing recruiters and hiring managers with data-backed insights based on information provided in your resume, including work experience, education, and other skills. If you have any questions or would like to request an alternative process, please contact us at CandidateHelp@alto.com. To learn about Alto Pharmacy's privacy practices including compliance with applicable privacy laws, please_ click here_.