Engineering Manager, Messaging & Applications Teams - CareMessage

About CareMessage

CareMessage is a social enterprise and the largest patient engagement platform for low-income populations in the United States. We deliver personalized health education and care coordination through text messaging — reaching patients where they already are, in the language they speak, at the moments that matter most. Unlike technology built for large health systems and adapted down, CareMessage is designed from the ground up for organizations serving low-income, historically marginalized communities.

Role Overview

The Engineering Manager for the Messaging & Applications teams owns and drives the technical direction of CareMessage's core product: the messaging platform that powers patient communication for our customers, and the core application that providers use every day. CareMessage supports over 400 safety-net healthcare organizations, including federally qualified health centers and free clinics, that care for low-income and underserved patients nationwide, and your teams build the product that millions of patients experience directly. This is a leadership role over existing teams: their systems and roadmaps are already in place, and your job is to lead, deepen, and scale them.

The Messaging team builds and maintains the systems that drive all outbound and inbound patient communication (SMS, voice, and multimedia), powered by Twilio, and we are investing in AI-driven message categorization, multimedia messaging (MMS/RCS), intelligent delivery optimization, and consent management. The Applications team builds and maintains the core web application (a Ruby on Rails monolith with a JavaScript/TypeScript/React front end on Postgres and GCP) through which providers manage campaigns, patients, appointments, and messaging. Increasingly, this experience is enhanced by our solution recommendation engine and AI copilots that help providers determine and act on the right next step for each patient.

Core Requirements

• Proven Track Record: At least 5 years of successful experience as an Engineering Manager over product/application engineering, in two or more early-to-growth-stage remote startup environments.
• Strategic Leadership: Demonstrated ability to lead and drive the delivery of long-term technical projects across multiple teams, driving measurable outcomes.
• Technical Proficiency: Strong technical acumen with a deep understanding of building and operating customer-facing web applications (web frameworks, relational databases, APIs, cloud infrastructure).
• Modern & AI-Assisted Engineering: A track record of adopting modern development practices and leveraging AI-assisted tooling (e.g., AI coding assistants and LLM-based workflows) to raise engineering velocity and quality, with the judgment to apply them responsibly in a healthcare/PHI context.
• Hands-on Experience: The ability to get hands-on with the codebase when needed to help debug issues, review technical work, and unblock the team.
• Geographic Requirement: This role requires the candidate to reside within the United States.

Preferred Experience

• Experience managing teams that operate high-volume messaging/communications systems and/or customer-facing SaaS web applications.
• Experience working in a Healthcare technology environment and the requisite Security and Compliance requirements (HIPAA/PHI); familiarity with messaging compliance (TCPA, opt-in/opt-out, carrier/10DLC).
• Experience with our Tech Stack: Ruby on Rails, JavaScript/TypeScript/React, Postgres, GCP, Twilio (SMS/voice), Metabase.
• Background in TDD engineering environments.

Job Responsibilities

• Directly oversee and guide the Messaging and Applications teams (engineers, a team lead, and QA across the two teams), providing consistent, constructive feedback and performance reviews.
• Actively participate in the recruitment, interviewing, and retention of top-tier engineering talent.
• Champion the adoption of modern, AI-assisted engineering practices across both teams by evaluating new tools and setting responsible-use guardrails.
• Work with engineering and product leadership to refine and execute the technical strategy for a reliable, compliant, and scalable core product.
• Play a hands-on role when necessary: communicating via prototypes, unblocking the team, and reviewing technical work.
• Contribute to the team by participating in the On-Call (PagerDuty) rotation.