Pelairo Inc.

At Pelairo we're building the most intuitive and flexible Laboratory Information Management System (LIMS) on the market. "Manage the lab, not the LIMS!" 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. What you'll do: - 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. What makes you a great fit: - 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".