Synthesis Health
Who We AreWe're a mission- and values-driven company with tremendous dedication to our customers. Our 100% remote team is dedicated to a common goal – to revolutionize healthcare through innovation, collaboration, and commitment to our core values and behaviors.
About the Opportunity
This is a high-impact, high-autonomy role at the center of our IT and security operations. As our IT Security Engineer, you'll own the day-to-day administration and ongoing maturation of a modern Microsoft 365 E5/E7 environment supporting a fully remote healthcare SaaS company. You'll be the primary technical hand across identity, endpoints, security tooling, and compliance evidence generation, working directly on the systems that keep our clinical AI platform secure and our five compliance frameworks audit-ready. This is a small-team environment where you'll have real ownership and the latitude to improve, automate, and architect rather than just maintain. If you want your decisions to matter and your work to be visible, this is the role you have been searching for.
Key Responsibilities
End-user IT support: first point of contact for the company across Microsoft 365, identity, devices, SaaS access, and general technology issues, with ownership of the internal support queueEndpoint administration across macOS and Windows: Intune compliance and configuration policies, application deployment, endpoint DLP, OS update managementEntra ID operational ownership: Conditional Access lifecycle, group and license hygiene, access reviews, PIMMicrosoft Purview, Sentinel, Defender, and Global Secure Access: ongoing tuning, alert triage workflows, evidence pipelines, secure access policy managementAutomation and integration: building and maintaining workflows across our SaaS estate using APIs, webhooks, and appropriate toolingJoiner-mover-leaver execution and the tooling that supports itCompliance evidence generation and audit support across our compliance frameworksSaaS administration hygiene: Vanta posture, app registrations, license reconciliationIdentifying opportunities to improve, replace, or consolidate our existing toolingWhat We're Looking For
Microsoft Sentinel: KQL, data connectors, analytics rules, workbook authoring, cost managementMicrosoft Purview hands-on: DLP, sensitivity labels, retention, eDiscoveryMicrosoft Defender XDR: Defender for Endpoint, Defender for Office 365, Defender for Cloud AppsmacOS administration: configuration profiles, shell scripting (bash, zsh)Experience operating in a one-person or small-team IT environment, with the prioritization judgment that comes from it.Preferred Qualifications
Microsoft 365 E5 or E7 license tier experience specificallyMicrosoft Security Copilot exposureMicrosoft Global Secure Access: Internet Access, Private Access, traffic forwarding profilesmacOS administration at depth: declarative device management, Platform Single Sign-OnGCP IAM exposure: Workload Identity Federation, org policies, IAM roles and bindingsVanta or comparable GRC automation toolingEnterprise password management administrationHITRUST CSF i1 or r2 familiarityISO 27017 and ISO 27018 cloud-specific control familiaritySCIM provisioning experience across multiple SaaS applicationsSelf-hosted automation platform experience including deployment, upgrades, and monitoringMicrosoft Graph PowerShell SDK at an advanced level: app-only authentication, custom Entra app registrationsConditional Access policy design at scale, including structured policy taxonomiesAzure VM and Docker Compose administrationSharePoint Online administration and Viva ConnectionsApple Business Manager and Automated Device Enrollment workflowsWindows Autopilot deployment experienceExperience supporting a SOC 2 Type II or ISO 27001 Stage 2 audit as the named technical owner.Why You Should Join Us
Solve Our Toughest Puzzles: This is a high-leverage role. You will be working on the most impactful technical challenges that are critical to the company's success.Define the Architecture: You won't just be maintaining a system; you will be a primary author of its future state, with the autonomy to make it happen.Lead from the Front: This is a chance to establish yourself as a key technical voice in a rapidly growing company.Competitive Compensation & Benefits: We offer a strong salary, a 100% remote culture, and significant opportunities for growth.We are a values-driven company. Our values:
Clinical service first.Collaborate with our customers.Listen, respect, learn.Innovate to excel.The behaviors we look for:
Be nice.Be creative.Be honest.Be helpful.Compensation and Benefits
Typical salary range for this position is $105,000 - $125,000. However, Synthesis participates in location based hiring and salary ranges can be adjusted based on candidate's residence.
Other benefits include, but are not limited to: Medical, Dental, Vision, "Use as needed" vacation policy, and participation in our employee option program.
Synthesis Health is an Equal Employment/Affirmative Action employer. We do not discriminate in hiring on the basis of sex, gender identity, sexual orientation, race, color, religious creed, national origin, physical or mental disability, protected veteran status, or any other characteristic protected by federal, state, or local law.
Read LessSynthesis Health
Who We Are
We're a mission- and values-driven company with tremendous dedication to our customers. Our 100% remote team is dedicated to a common goal – to revolutionize healthcare through innovation, collaboration, and commitment to our core values and behaviors.
About the Opportunity
We are looking for a Principal Platform Engineer to serve as a hands-on architect of our system's evolution. In this role, you will tackle our most substantial engineering challenges: ensuring the reliability, performance, and scalability of our distributed systems while driving the maturation of our technical stack.
This is a leadership role for a hands-on technical visionary. You will focus on solving deep, structural problems in the overall system to achieve 99.99% reliability and massive scalability. You will drive key maturation issues regarding our architecture, identifying the critical path for eliminating bottlenecks, reducing complexity, and enabling our engineering teams to ship faster with greater confidence. As a key voice on the Architecture Review Board (ARB), you will shape the technical direction of the entire organization.
If you are an expert in high-scale distributed systems and have the scars and success stories to prove it, this is your chance to build a legacy.
Key Responsibilities
System Reliability, Performance, & Scalability
Solve Substantial System Challenges: You will identify and lead the resolution of the most complex, systemic problems affecting our platform's stability and speed.Architect for Scale: You will design the strategies that allow our system to handle exponential growth, focusing on database scaling, caching architectures, and asynchronous processing throughput.Reliability Engineering: You will define and drive the adoption of patterns that ensure system resilience, including circuit breaking, graceful degradation, and active-active failover strategies.Stack & Architecture Maturation
Drive Technical Evolution: You will lead the maturation of our technical stack, ensuring our libraries, frameworks, and infrastructure choices evolve to meet future business needs.Eliminate Structural Bottlenecks: You will look beyond code-level optimization to solve structural issues in our database layer, messaging infrastructure, and deployment pipeline.Technical Governance: As a senior leader on the ARB, you will enforce architectural rigor, preventing the introduction of new technical debt while establishing standards for long-term maintainability.Strategic Leadership & Influence
Cross-Organizational Impact: You will influence the technical direction across multiple product areas, reconciling conflicting architectural goals to serve the broader business.Elevate the Platform: You will mentor Staff and Senior engineers, helping them understand distributed consensus, eventual consistency, and the trade-offs of complex distributed systems.What We're Looking For
Elite Distributed Systems Experience: 10+ years of software engineering experience, with a heavy focus on designing, optimizing, and operating high-scale distributed systems.Architectural Evolution: You have a proven track record of evolving complex systems and driving technical maturity in a fast-paced environment.Language Fluency & Strategy: Deep expertise in TypeScript/Node.js is required. As we pivot performance-critical paths toward Go, experience leading similar language transitions or strong Go proficiency is highly desirable.Deep Technical Mastery: Expertise in defining Service Level Objectives (SLOs) and Error Budgets.Deep knowledge of synchronous (Websockets, gRPC, REST) vs. asynchronous (Kafka/PubSub) communication patterns.Advanced database design patterns (sharding, partitioning, CQRS).Expertise in container orchestration (Kubernetes) at scale.Visionary Leadership: You can identify critical long-term technical challenges months or years in advance and mobilize the organization to address them.Communication at Scale: You can effectively communicate the business value of architectural investments to executive leadership while diving deep into the code with engineers.Preferred Qualifications
Healthcare Domain Experience: Experience in healhtech or regulated industries is a plus.Compliance & Standards: Deep familiarity with healthcare data standards (DICOM, HL7, FHIR) and compliance regulations (HIPAA) is a significant advantage.High-Performance Database Tuning: Deep experience tuning PostgreSQL or similar relational databases for massive concurrency.Breaking Up The Monolith: Experience migrating a monolithic database architecture to microservices is a plus.Why You Should Join Us
Solve Our Toughest Puzzles: This is a high-leverage role. You will be working on the most impactful technical challenges that are critical to the company's success.Define the Architecture: You won't just be maintaining a system; you will be a primary author of its future state, with the autonomy to make it happen.Lead from the Front: This is a chance to establish yourself as a key technical voice in a rapidly growing company.Competitive Compensation & Benefits: We offer a strong salary, meaningful equity, a 100% remote culture, and significant opportunities for growth.We are a values-driven company. Our values:
Clinical service first.Collaborate with our customers.Listen, respect, learn.Innovate to excel.The behaviors we look for:
Be nice.Be creative.Be honest.Be helpful.Compensation and Benefits
Typical salary range for this position is $170,000 - $205,000. However, Synthesis participates in location based hiring and salary ranges can be adjusted based on candidate's residence.
Other benefits include, but are not limited to: Medical, Dental, Vision, "Use as needed" vacation policy, and participation in our employee option program.
Synthesis Health is an Equal Employment/Affirmative Action employer. We do not discriminate in hiring on the basis of sex, gender identity, sexual orientation, race, color, religious creed, national origin, physical or mental disability, protected veteran status, or any other characteristic protected by federal, state, or local law.
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