Engineering at CareMessage

As a small, nimble team, having a high-quality code base is key to operating effectively.

At CareMessage, we’re building a platform that helps millions of underserved patients improve their health with preventive care and appointment reminders, local resources, and health coaching through text messaging. Given the real-world implications, writing high-quality code that we can ship quickly and sustainably is paramount. Starting with the technical interview process, we require engineers to code. Similarly, we expect them to write tests to cover their code. We have between 95-100% code coverage on our repositories and are thoughtful about how we maintain tech debt, reviewing it regularly and following a defined process to pay it down. Last but not least, we use Ansible and Terraform to maintain our infrastructure as code to minimize misconfiguration issues and have a CI/CD build pipeline that runs in under 20 minutes upon merge. All engineers participate in an on-call schedule, but since we have such a high-quality code base, that means there are rarely major issues.

We practice what we preach.

We’re dedicated to improving health outcomes not just for others, but for ourselves, too. In addition to nine wellness days that can be used for self-care or anything that comes up in life, we also have half-day Fridays year-long. Team members have access to fitness and mindfulness programs, and we believe in actually taking vacation to recharge, which is why we have a company-wide ~5-day mid-year break and a ~5-day end-of-year break. In addition to 15 days PTO and 18 paid holidays, employees are also eligible for a one-month (20 working days) sabbatical after their four-year anniversary. Folks have used this time to travel (one team member who lives in Brazil is taking his daughter to Disney World in Florida), visit loved ones, or take up a new hobby. During the pandemic, we’ve been flexible so that folks who wanted to travel could wait to take their sabbaticals. We even have some team members who are coming up on their second sabbaticals!

Tatiane (Software Engineer, fourth from left) enjoying one of her favorite hobbies Muay Thai.

Building a diverse team is core to our mission.

We’re working to create a world where all people, regardless of income or background, achieve equitable health outcomes. Doing so requires bringing a diverse set of people and backgrounds together – something we’re looking to continue to invest in and improve on with future hiring. Currently, we have folks on the team who span the U.S., India, and Brazil, and are proud of this geographic and cultural diversity. We also encourage you to meet our diverse leadership team and board of directors here.

At the end of the day, we’re not looking for a certain brand name or degree on your resume. Fun fact: Jeremy, our VP of Engineering, has a BA in Communications. We welcome folks who have non-traditional backgrounds and only care about whether you can write quality code, are growth-oriented, and most importantly, are a nice human.

Orit, Principal Product Manager, (second from left) and Cecilia, Co-founder and VP of Product, (front right) enjoying some time with CareMessage colleagues on a company retreat.

Whether it’s a home office, coffee shop, or WiFi-enabled RV – we believe in working from wherever you are.

We’ve been a fully distributed, global team since 2019 and are big fans of having the flexibility to get work done from wherever you are, whenever suits you best. Our strong documentation culture ensures everyone has context and access to the information they need. This begins with a robust onboarding process, where we have weekly rubrics outlining what we expect new hires to be learning, starting from their first day through week eight.

The emphasis is always on delivering consistently, not the number of hours you’re in front of your computer. Want to go to the gym during the middle of the day? You’ll be in great company since several team members do so regularly. Another one of our engineers is in a golf league, so he leaves early once a week to hit the links. While we strive to overlap between 10am and 2pm EST to allow for synchronous meeting times and collaboration, we’re flexible and don’t expect you to be available on Slack all the time. We simply ask that you communicate with the team so we’re all on the same page.

Chris (Senior DevOps Engineer) enjoying his golf league hobby.

Our status as a non-profit gives us a unique edge to effect real-world change.

Unlike many SaaS companies where product leaders make all of the decisions, our sustainable business model as a 501(c)(3) nonprofit means we always put our customers’ needs first. Not only are we 70% self-supported, but we also have large institutional investors such as Google.org and Johnson & Johnson that invest because they know our platform works. Clinical studies show our model improves the health outcomes of underserved patients and by partnering with 400 safety net organizations in 43 states, we’re able to reach millions of people every month. That’s why we only take monetary funding with the understanding that we’ll build the features that have the greatest impact on the most customers, not because one particular customer or donor thinks we need something.

Ultimately, we look at our data, user interviews, and what's happening in the market to drive our strategy. For example, when COVID-19 hit, we saw a 10x increase in our mass-messaging feature as Federally Qualified Health Centers and Free Clinics worked to deliver trustworthy information and help patients stay on top of chronic conditions. In addition to bolstering our platform to serve this need, we also provided videos in English and Spanish to educate patients about telehealth, teach them how to use the most common platforms, and help them better prepare for video calls.

CI shouldn’t take more than 30 minutes to run – ideally less than 20.

We often ship to production multiple times a day and invest in automated testing, monitoring, and reporting (we use CircleCI for CI/CD). Engineers own their code’s quality throughout the software development process and we avoid latency by keeping CI under 30 minutes. When Jeremy (VP of Eng) first started, it was taking an hour and a half. We invested resources, refactored, and it now takes around 12-15 minutes to run our full test suite, build, and deploy.

Creating an inclusive environment is top of mind in everything we do.

Our mission to improve health outcomes for low-income communities and communities of color isn’t just theoretical, it’s personal. Vineet (co-founder and CEO) was inspired to use text messaging to fill a gap in patient care after his experience volunteering at St. Vincent’s Free Clinic in Galveston, Texas in the wake of Hurricane Ike. He turned down his medical school acceptance and partnered with fellow Stanford classmate, Cecilia (co-founder and VP of Product), to found CareMessage. Having grown up in a low-income immigrant household, Cecilia brings an invaluable perspective on how to design products and build technology for underserved communities. She’s also an advocate for diversity and inclusion in the broader tech industry, thanks to her work collecting and publishing data on Latina tech founders.

Internally, we’re committed to fostering inclusivity by continually reviewing and improving our equitable hiring processes. When it comes to compensation, we offer competitive and equal pay regardless of location. If we find we need to increase the salary for a particular role to be competitive, we immediately raise everyone in that role’s salary as well. What’s more, we allocate time and budget investments to our ERGs, which include BIPOC, Parents of CareMessage, and Women of CareMessage. We also place an emphasis on making space for everyone’s voice to be heard, not just the loudest person in the room. As we grow, we look to our team members to participate in these conversations, help mentor one another, and play an active role in shaping an inclusive culture.

Renan and Bruno, Senior Software Engineers (first and second from left) with other CareMessage colleagues at our Disneyland company retreat circa 2019.

CareMessage is a great place to grow your career, while managing a full life outside of it.

At CareMessage, we know that part of having a rich and rewarding life is caring for others – kids, parents, pets, gardens, and the people in your community. We offer flexibility that our employees value. Whether it’s taking some time to care for a sick family member, leaving early to carpool to after-school activities, or taking a midday stroll to the dog park, we get it. For instance, Marco walks to pick up his daughter from school and we’re happy to accommodate so that he signs on a little later to the engineering standup.

We offer eight weeks paid parental leave for all teammates welcoming biological or adopted children, as well as access to concierge support for childcare and family planning services. Regardless of if you’re a parent to a human, pet, plant (or none of the above), if joining a quickly growing, mission-driven tech startup speaks to you, don’t hesitate to reach out!

Tatiane (Software Engineer) having some fun in the sun with loved ones and her dog.