Senior Full-Stack Engineer, PHP

Arbiter is reimagining how healthcare works - not by adding more point solutions, but by building the infrastructure that runs the system. We’re designing the intelligent operating spine that unifies data, automates workflows, and aligns incentives across providers, payers, and patients. Our platform embeds AI into real-world care and revenue cycle operations, transforming administrative chaos into orchestrated execution.

We’ve just closed one of the largest early-stage raises in health tech history - backed by some of the most influential players in the industry who collectively manage millions of lives and billions in spend. Paired with a powerhouse board and executive team, we have the capital, context, and relationships to move quicker than anyone - tackling the problems we know intimately and scaling what works. Our MVP is already live with hundreds of providers managing hundreds of thousands of lives, and improving daily based on real-world feedback.

At Arbiter, engineers don’t just ship features - they shape the foundation of an industry in flux. You’ll work alongside a small, elite team of product leaders and technologists from FAANG and top startup and healthcare orgs to architect systems that handle millions of patient records, build AI agents that execute critical healthcare workflows, and design platforms that major health entities depend on daily. Every line of code you write shapes how a $4T industry operates.

The role is on-site, based in our New York City or Boca Raton office - a fast-paced, collaborative environment where great ideas move quickly from whiteboard to production.

Pay Transparency

The annual base salary range for this position is $172,800-$237,600. Actual compensation offered to the successful candidate may vary from the posted hiring range based upon work experience, and/or skill level, among other things. This role is also eligible for an equity package.

We’re assembling a team of exceptional builders and are offering hyper-competitive benefit packages, including unlimited PTO, and other great benefits to attract and reward standout performers. If you’re looking for purpose, pace, and the opportunity to modernize one of the largest industries in the world, let’s talk.

Responsibilities of the Senior Full-Stack Engineer

• Design, develop, and implement scalable and reliable web applications using PHP.

• Contribute to system architecture ensuring scalability and performance.

• Design and manage complex relational databases (MySQL/PostgreSQL).

• Build responsive front-end interfaces using JavaScript, HTML, CSS, and Twig.

• Use modern CI/CD and orchestration tools, including k8s, GL pipelines, and IaC

• Collaborate with product managers and other teams.

• Provide technical mentorship and perform code reviews.

• Implement comprehensive testing strategies.

• Participate in hiring and onboarding.

Minimum Qualifications

• 7+ years Full-Stack engineering with strong PHP experience.

• Excellent proficiency with PHP frameworks, especially Symfony, and ORM tools like Doctrine

• Strong SQL knowledge.

• Extensive experience with relational databases, specifically MySQL or PostgreSQL, including schema design, query optimization, and performance

• Experience in distributed systems and container orchestration platforms, specifically Kubernetes.

• Front-end proficiency in JavaScript, HTML, CSS.

• Strong testing practices.

• Technical leadership and cross-functional collaboration skills.

Preferred Qualifications

• Experience with React, Next.js, Stimulus.

• Background in healthcare or finance systems.

• Familiarity with GCP or AWS.

• Expertise in API design and optimization.