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Software Development Engineer in Test (SDET)

HealthEx | Full-time | Bay Area/Hybrid

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About HealthEx

HealthEx is a healthcare interoperability company building the connective tissue between patients, their health records, and the AI-powered applications transforming how care is delivered. We believe that people should own their health data — and that the apps, agents, and clinicians they trust should be able to act on it seamlessly.

We’ve built industry-first integrations with Anthropic’s Claude, Microsoft Copilot, and Salesforce, and we work with leading payers and digital health applications to make unified health records accessible wherever care decisions happen. Our platform connects to national health information exchanges (TEFCA / QHINs), FHIR endpoints, and clinical document sources — and the engineering team builds every layer of that stack.

Role overview

We're looking for an SDET to design, build, and own the test automation architecture for our consent-based health data platform. In this role, you’ll build scalable automation frameworks, lock down sanity and regression suites in CI/CD, and drive end-to-end quality across our entire stack—from identity verification and FHIR data pipelines to AI agents powered by our MCP server.

This role is ideal for someone who loves solving complex testing problems. Our data originates from external systems we don’t control, where privacy and consent workflows have zero margin for error, and AI models are inherently non-deterministic. Our innovative testing strategies will be clearly novel in a growing and very dynamic market.

What you'll bring

Required
The ideal candidate will need to have these capabilities:

4+ years in software testing and automation, with at least 2 years building or significantly extending automation frameworks
Strong coding skills in TypeScript/JavaScript or Python (Java is a plus)
Hands-on experience with modern tools such as Playwright, Cypress, or Selenium for UI testing, and REST Assured, Postman/Newman, Pytest, or similar for API testing
Solid understanding of REST APIs, JSON, HTTP, and OAuth 2.0/OIDC
Experience with CI/CD (GitHub Actions, Jenkins, GitLab CI, or similar) and version control with Git
Familiarity with cloud environments (AWS preferred), Docker, and containerized services
A strong eye for edge cases and a habit of thinking about privacy, security, and data integrity
Clear written and spoken communication

Nice to have
Here are some additional skills that would be considered as upside:

Experience with healthcare interoperability standards: FHIR (R4), SMART on FHIR, C-CDA, USCDI, or networks like TEFCA, Carequality, or CommonWell
Experience in Web Applications Automation
Experience testing EHR integrations (for example Epic or Cerner/Oracle Health)
Hands-on work with LLMs, AI agents, or MCP servers, including building evals or testing applications that use AI models
Performance and load testing experience (k6, JMeter, Locust)
Experience with observability tools (New Relic, Datadog, CloudWatch) and log-based debugging
Work in a HIPAA-regulated or SOC 2-audited environment

What you'll do

Framework & infrastructure

Design, build, and maintain a scalable automation framework covering UI, API, MCP, and integration testing
Add automated suites to CI/CD pipelines with quality gates, parallel runs, clear reports, and alerts for flaky tests
Build test data tools, including synthetic patient identities, FHIR/C-CDA fixtures, and mocks or sandboxes for outside health networks

Sanity & regression automation

Automate sanity suites that run on every deployment and confirm core flows work: sign-up and identity verification, consent grant and revoke, record retrieval, and data delivery
Keep a dependable regression suite and a smoke-test plan for production releases
Write synthetic monitors that check key paths in production

Feature automation

Work with Product and Engineering early, reviewing requirements (PRDs) and acceptance criteria and helping shape how features can be tested
Automate new features across the Wallet app, partner APIs, and consent management
Check FHIR R4 resources against USCDI v3 expectations, including conditions, labs, medications, allergies, immunizations, procedures, vitals, and clinical notes

Consent, privacy & security testing

Build tests that prove data flows only where the user consented: provider exclusions, partner scopes, revocation, and audit trail accuracy
Test authentication and authorization flows (OAuth 2.0, SMART on FHIR) and negative, abuse-case scenarios
Support HIPAA and SOC 2 compliance with traceable, auditable test evidence

AI & MCP server testing

Build automated tests for MCP server tools covering schema validation, parameter handling, errors, pagination, latency, and access limited to consented data
Create evaluation harnesses for AI features, including golden datasets, LLM-as-judge scoring, checks for made-up content, and grounding checks against the source records
Test how AI clients (Claude, Copilot, and others) call HealthEx MCP tools, and catch regressions when models or prompts change
Use AI coding assistants and agents to speed up writing, maintaining, and triaging tests

Quality leadership

Track and report quality metrics: coverage, flakiness, defect escape rate, and release readiness
Investigate failures using logs and observability tools, and write clear, reproducible bug reports
Promote a testing mindset across engineering teams

What makes this special?

Here are some points that we believe that makes this role unique:

Category-defining partnerships
We are live in Production with Anthropic’s Claude, Microsoft Copilot, and Salesforce - powering AI agents with real patient data in ways no one else has shipped. You’ll build the infrastructure that makes it all work.

Learn from an exceptional team
You’ll work alongside engineers with deep experience at high-growth startups and industry-leading tech companies. This is a tremendous opportunity to level up your skills in a hands-on environment where senior engineers invest in your growth — through pairing, code review, and real mentorship, not just Slack messages.

Meaningful scale in a small team
With a product team of ~5, every engineer’s work ships to production fast and has outsized impact. You won’t spend months waiting for your code to reach users.

The right moment in healthcare
TEFCA is rolling out, CMS interoperability mandates are tightening, and AI is finally making unified patient records actionable. HealthEx sits at the center of all three trends.

An environment built for growth
We actively invest in our team’s ability to learn, experiment with AI productivity tools, and reimagine how their roles evolve. Your career trajectory here will look different after working on the ground floor of a compelling healthcare venture.