Full Stack Engineer

**About Meadow Biosciences** Meadow Biosciences is a physician\-supervised precision care platform for autism spectrum disorder, operating across all 50 states through a subscription and compounding\-pharmacy model. Our care is grounded in a systems\-biology approach to neurodevelopmental conditions. We're a small, fast\-moving team building real clinical infrastructure that families depend on. We're hiring our founding full\-stack engineer to own the platform end to end — and to be the technical center of gravity for everything Meadow ships. **The role** This is a hybrid builder\-and\-owner role. Roughly half your time drives Meadow's own product roadmap — the patient\-facing site, subscription flows, and internal tooling. The other half, you work inside our infrastructure partner's (ClinicTitan) build pipeline: coordinating, reviewing, and quality\-checking the work delivered on our behalf, and holding it to a standard. To be direct about it: you'll be both the person who builds and the person who keeps a vendor's delivery on track. If you like broad ownership and dislike narrow lanes, this is built for you. If you want to be handed perfectly scoped tickets, it isn't. There is no hand\-off between "frontend" and "backend" here. You carry the ticket to done, on a production, HIPAA\-regulated platform. **What you'll work on** * Product features across the clinical workflow: intake forms, provider queues, prescription routing, patient portals, video visits, and billing dashboards * Multi\-tenant infrastructure: adding brand tenants, customizing white\-label experiences, and keeping per\-tenant data strictly isolated * Backend services in Python (FastAPI on ECS Fargate), async workers on Lambda/SQS, and a Node.js API layer * A Vue 3 single\-page app: rich clinical forms, real\-time video, and charting dashboards * Infrastructure\-as\-code on AWS via Terraform * Database work: schema migrations, query optimization, and multi\-tenant data modeling on PostgreSQL **What we're looking for (the real bar)** * You've shipped features in production **across the full stack** — not just touched each layer * Strong in **TypeScript** and a modern SPA framework (we use Vue 3; React experience transfers) * Solid **Python** (FastAPI or equivalent) for backend services and APIs * Comfortable in **AWS** and infrastructure\-as\-code — you can stand up and reason about cloud infra, ideally with Terraform * Working knowledge of **PostgreSQL** — schema design, migrations, query authoring * You can **own a codebase solo** and onboard fast without being walked through every file * You default to simple, working solutions and read error messages before asking for help **Bonus points (not required)** * Node.js / Fastify, Prisma ORM * Deep AWS service experience (Cognito, API Gateway, CloudFront, SQS, SES, WAF, VPC networking) * Pinia, Vue Router, Tailwind, Vee\-Validate/Zod, Vitest, Playwright * LiveKit / WebRTC video * HIPAA / healthcare data handling * Neon se