Overview
Healthcare tech (healthtech, digital health) companies build software for patient care, medical records, telehealth, clinical workflows, medical devices, and health data analytics. These companies operate under regulations like HIPAA, HITECH, FDA requirements, and various state health privacy laws.
Engineering in healthcare involves protected health information (PHI), patient safety considerations, and high reliability requirements. A bug in healthcare software isn't just inconvenient—it can affect treatment decisions, expose sensitive medical data, or in extreme cases, harm patients.
The good news: engineers don't need medical backgrounds or clinical experience. Domain knowledge is learned on the job. What matters is the mindset—comfort with regulated environments, attention to security, and understanding that healthcare software carries real-world consequences. Many excellent healthtech engineers come from fintech, government, or any background where careful, auditable development was expected.
Why Healthcare Hiring is Different
The Regulatory Reality
Healthcare operates under a complex web of regulations that shape how software is built:
| Regulation | Applies To | Engineering Impact |
|---|---|---|
| HIPAA | Anyone handling PHI | Encryption, access controls, audit logging, breach notification |
| HITECH | Electronic health records | Security requirements, meaningful use standards |
| FDA | Medical devices, SaMD | Quality management systems, 510(k) clearance, design controls |
| State Laws | Varies by state | Some states have stricter privacy requirements than HIPAA |
| SOC 2 | B2B healthtech | Security controls, compliance attestation |
This isn't bureaucracy for its own sake. These regulations exist because healthcare software handles the most sensitive personal data that exists—medical records, diagnoses, treatment histories. Engineers who understand this context build better systems.
What This Means for Hiring
You're not looking for compliance officers—that's a separate function. You're looking for engineers who:
- Take patient privacy seriously (not "we'll encrypt it later")
- Think about access controls and audit trails
- Document their work properly
- Follow security best practices without being reminded
- Ask "who should have access to this data?" before building features
- Understand that "move fast and break things" doesn't apply to healthcare
This mindset exists across industries. Fintech, government contractors, defense—anyone from a regulated environment will adapt quickly to healthcare requirements.
What Engineers Actually Need (And Don't)
Required: Compliance Mindset, Not Medical Degrees
Engineers don't write the HIPAA rules. They build systems that comply with them. The actual requirements:
Security-Conscious Development
- Encryption at rest and in transit as default
- Understanding of access control patterns (RBAC, ABAC)
- Audit logging as standard practice
- Secure coding habits (input validation, injection prevention)
- Data minimization awareness
Reliability Focus
- Testing beyond the happy path
- Thinking about failure modes
- Monitoring and alerting awareness
- Understanding that downtime in healthcare can affect patient care
Documentation Discipline
- Code that others can audit and understand
- Change tracking and version control hygiene
- Requirements traceability (knowing why code exists)
- Clear API documentation
Process Tolerance
- Following deployment procedures
- Code review participation
- Working within change management frameworks
- Accepting that some decisions require compliance review
Not Required: Medical Degrees or Clinical Experience
This is the biggest misconception in healthtech hiring. Engineers learn medical domain knowledge on the job. An EHR engineer doesn't need to understand pharmacology. A telehealth engineer doesn't need nursing credentials.
What matters:
- Can they learn your specific domain?
- Do they ask good questions about workflows?
- Can they translate clinical requirements into technical solutions?
- Are they comfortable saying "I need to understand this better before building it"?
The best healthtech engineers often come from:
- Fintech (HIPAA and PCI-DSS share principles)
- Government/defense (security-cleared environments)
- Enterprise software (complex compliance requirements)
- Any regulated industry
- General software engineering with strong fundamentals
The Certification Question
HIPAA training is provided by employers—engineers aren't expected to arrive certified. What matters is receptiveness to learning why these requirements exist.
The exception: if you're hiring for security-specific roles (Security Engineer, Privacy Engineer), relevant certifications like CISSP or HCISPP demonstrate domain commitment.
Companies You're Competing With
Understanding your competition helps position your opportunity appropriately.
Tier 1: Healthtech Giants
Epic, Cerner (Oracle Health), Veeva
- Established market leaders
- Stable employment
- Comprehensive benefits
- Often location-specific (Epic in Madison, etc.)
To compete: More modern tech stacks, startup pace, equity upside, remote flexibility.
Tier 2: Well-Funded Digital Health
Oscar Health, Ro, Flatiron Health, Teladoc, Cityblock
- Competitive compensation ($180-280K+ for senior)
- Strong engineering cultures
- Mission-driven
- Modern tech stacks
To compete: You probably won't on pure compensation. Compete on specific domain interest, stage preference, or role ownership.
Tier 3: Health Tech Scale-ups
Thirty Madison, Hinge Health, Cerebral, Color Health
- High growth
- Meaningful equity
- Mission alignment
- Smaller, more impact per person
To compete: Early-stage equity, ownership, specific niche, team and culture.
Tier 4: Traditional Healthcare IT
Hospital systems, health plans (Kaiser, UnitedHealth)
- Stable employment
- Good benefits
- Lower equity/upside
- Can be bureaucratic
To compete: Speed, ownership, equity upside, less legacy code.
Your Positioning
Be honest about where you sit. If you're a seed-stage healthtech startup, you're not competing with Oscar on compensation. You're competing on:
- Early-stage equity potential
- Ownership and direct impact
- Specific mission passion (maybe you're solving a problem they don't touch)
- Team and culture
- Flexibility and autonomy
Compensation Reality: Healthtech Pays Well
Healthcare tech offers competitive compensation, typically 5-15% above general market rates for comparable roles. Why?
Higher Bar
Regulated environments require more careful engineering. You're paying for attention to detail and security awareness that not all engineers have.
Competitive Market
Well-funded digital health companies compete aggressively for talent. Oscar, Ro, and others have raised the compensation bar.
Mission Premium
Engineers who want mission-driven work have options. You need competitive compensation to be one of them.
Risk Premium
Engineers building systems where bugs affect patient care command higher salaries.
Salary Benchmarks (US Market, 2026)
| Level | General Market | Healthtech Premium | Healthtech Range |
|---|---|---|---|
| Mid (3-5 YOE) | $130-160K | +5-10% | $140-175K |
| Senior (5-8 YOE) | $160-200K | +10-15% | $175-230K |
| Staff (8+ YOE) | $200-260K | +10-15% | $220-300K |
Ranges vary significantly by location, company stage, and specific domain.
Equity Considerations
Healthtech startups often offer meaningful equity packages. Unlike some industries where revenue models are speculative, healthcare has clear paths to revenue (contracts with health systems, insurance billing, subscription models), making equity more evaluable.
For candidates, healthtech equity can be attractive because:
- Healthcare spending is massive and growing
- Business models are often understandable
- Many healthtech companies have clear paths to profitability
- Regulatory complexity creates competitive moats
Interview Focus: What Actually Matters
Technical Assessment
Standard engineering assessment applies. For healthtech-specific signals:
System Design
- How do they handle sensitive data?
- Do they think about access controls?
- Audit logging considerations?
- Data retention and deletion?
- Encryption in their designs?
Coding
- Error handling practices
- Input validation habits
- Testing approach (especially edge cases)
Behavioral Signals
Compliance Comfort
"Tell me about a time you worked in a regulated environment or had to follow strict data handling processes. How did you approach it?"
Good: Understands why processes exist, works within them constructively
Red flag: Sees all process as bureaucracy, wants to circumvent
Privacy Mindset
"Walk me through how you'd handle sensitive user data in a feature you're building."
Good: Encryption, access controls, audit logging, data minimization, "need to know" thinking
Red flag: "We'd just store it in the database"
Reliability Focus
"Tell me about a production incident you were involved in. What happened and what did you learn?"
Good: Blameless analysis, systematic improvement, monitoring additions
Red flag: Blame-focused, no systematic learning
Mission Alignment
"What draws you to healthcare technology?"
Good: Genuine interest in patient outcomes, healthcare improvement
Red flag: Just chasing a paycheck (fine for many jobs, but healthtech often requires extra motivation)
Building Your Healthtech Engineering Culture
Onboarding Compliance Context
Don't assume engineers understand why HIPAA matters. Invest in onboarding that covers:
- What regulations apply to your product
- Why they exist (real breaches, real consequences)
- How engineering decisions map to compliance requirements
- Who to ask when unsure
- What PHI is and how to handle it
Making Compliance Engineering-Friendly
The goal is building systems where doing the right thing is the easy thing:
- Secure defaults in frameworks and libraries
- Automated compliance checks in CI/CD
- Clear documentation of data handling requirements
- Engineering input on compliance tooling
- PHI handling patterns that are easy to follow
Mission Integration
Healthcare offers genuine mission alignment opportunities. Don't let this become performative:
- Share real impact stories (with appropriate privacy)
- Connect engineering work to patient outcomes
- Avoid generic "we're changing healthcare" messaging
- Be specific about how the product helps real people