About Birches Health:

Online gambling has taken over the US. Over 200 million Americans now regularly bet on sports and the rates of gambling addiction have skyrocketed since online gambling’s legalization. As widespread gambling creates record levels of addiction, debt, and bankruptcy, millions of problem gamblers still cannot access specialized, comprehensive care that they desperately need.

At Birches Health, we’re beating the online gambling epidemic with virtual therapy for gambling addiction from specialized clinicians. Our care is covered by insurance and state funding to ensure access to treatment for problem gamblers. We work with patients throughout their gambling addiction journey to improve clinical outcomes and reduce healthcare costs.

Our mission is to build the medical and technological infrastructure for behavioral addiction in the US to make sure millions of patients receive the highest quality clinical outcomes and path to recovery they deserve. We’re backed by leading healthcare and gaming investors including General Catalyst, AlleyCorp, Will Ventures, Defy, Haystack, Operator Partners, and C-suite angels at private and public companies.

Join us to bring addiction care into the present day.

About the Role

Birches Health runs on a connected ecosystem: our EHR, our CRM, our marketing automation platform, our claims and billing systems, insurance verification partners, and our own intake and engagement applications. Every client's journey, from first click to verified insurance to first appointment to paid claim, crosses half a dozen systems. The Growth Integrations Engineer owns the surface where those systems meet.

This is a new, dedicated role at the center of our growth engine. You will:

• Own integrations end-to-end: scope, design, build, ship, monitor, and iterate. You are the named owner of the flows that move client and payer data between systems, and of the webhooks, event pipelines, retries, idempotency, and observability that make them trustworthy.
• Build our Verification of Benefits (VOB) automation: insurance added or changed in our EHR → automated eligibility check → results written to our CRM and communicated to the client. This replaces hours of manual work per day with a minutes-long automated loop, and the build is underway now; you'll take it over and carry it forward.
• Deepen our claims and billing integration, building the translation layers between systems that disagree about data shapes, identity, and timing, so clean claims go out automatically and exceptions surface fast.
• Ship conversion integrations with our growth team: the automations that carry a lead from first touch to first appointment with no human glue work, including lifecycle messaging events, scheduling flows, referral mechanics, and provider matching.
• Strengthen client identity across systems: one person, one record, everywhere. Deduplication, canonical IDs, and the lookup mechanics that keep six systems telling the same story.
• Treat HIPAA as a design constraint, not an afterthought. Everything this role touches moves PHI; you'll work within BAA boundaries, least-privilege access, and audit trails from day one.

You'll join a small, senior, highly leveraged engineering team, work directly with the Head of Engineering and product leads, and see your work show up in revenue and client experience within weeks, not quarters.

Who You Are

• 4+ years building production backend systems and integrations: REST/GraphQL APIs, webhooks, event-driven pipelines, queues, third-party SDKs.
• You've owned an integration surface before, whether EHR, payer/insurance, CRM, payments, or another third-party-heavy domain, and you have the war stories to show for it: outages absorbed, retry storms tamed, duplicate-data bugs hunted down, vendors managed.
• Genuinely end-to-end: comfortable from infrastructure (GCP, Terraform) through backend services (TypeScript/Node.js or Python) to enough frontend to ship an internal admin tool. You'll spend most of your time server-side, but nothing on the path scares you.
• You set your own scope. Given "automate insurance verification," you can map the outcomes, edge cases, and failure modes, and write your own acceptance criteria; you don't wait for a fully specified ticket.
• You evaluate third-party services and libraries against explicit criteria (maintainership, footprint, supply-chain risk, fit for our stack), not popularity.
• Regulated-environment experience (HIPAA, SOC 2, or comparable). Healthcare is a plus; payer/insurance-data experience is a big plus.
• Working SQL (Postgres) and familiarity with data pipelines and warehouses (BigQuery or similar).
• AI-native working practice: you use tools like Claude Code daily and can show how they multiply your output without eroding your judgment.