Alto's mission is to fulfill medicine’s true purpose—to improve quality of life—for everyone who needs it.

Founded 2015
51-200 employees
  • Health Care Technology & Nursing
  • Headquarters address
    1400 Tennessee St #2, San Francisco CA 94107

    As one of the first 15 engineers at Alto, you will join a team creating a completely new pharmacy experience from the ground up. We use advanced technology and human empathy to advance a broken pharmacy industry into the modern era, and to make high-quality healthcare accessible to all. As an Alto Engineer, you will have the opportunity to build across the breadth of our products -- from our patient mobile application to our provider web dashboard to internal tools for our home grown pharmacy management system called Wunderbar. Our mission at Alto is to fulfill medicine’s true purpose—to improve quality of life—for everyone who needs it. We are building the best pharmacy for everybody, everywhere.

    As an Alto Engineer, you are a generalist who owns projects from end-to-end, enjoys problem-solving, and values the impact your work makes on our patients. You always put the patient experience first. You are scrappy and resourceful, unafraid to dive into an unknown project but humble enough to make mistakes and iterate. You thrive on speed and wearing many hats, and you enjoy working on different parts of the tech stack (we use Ruby on Rails, React, React Native, and Go).

    Within your 1st month, you will ship small features to Alto’s products. You’ll familiarize yourself with our tech stack, code review process, and codebase to learn how everything connects together. You’ll also shadow our Pharmacy Operations, Patient Care, and Fulfillment Teams to understand Alto from every perspective, and you’ll even speak to real patients on a support call. By your 2nd month, you will contribute to the planning, scoping, and code of a larger project. By your 3rd month, you’ll possess the confidence and skillset to own and ship a large project or feature. You’ll feel comfortable within our codebase and be able to tackle bugs independently.

    Example Projects of an Alto Engineer:

    • Fertility Project - The pharmacy is not a one-size fits all product. Using React to improve UI functionality for patients and Rails to simplify complex billing algorithms for providers and Pharmacy Ops, Alto elevates the experience of fertility patients by building specific features on our patient and provider dashboards to cater to their unique needs.

    • React Native Patient App - Building a patient mobile app from scratch in React Native for both iOS and Android, along with the API endpoints to integrate the app with Alto’s backend. This app enables patients to onboard, schedule deliveries, order refills, communicate with their pharmacist, and better understand their medications.

    • Expansion Project - Creating changes across all our backend systems and internal tools with Rails to support operating pharmacies in multiple locations. This includes scaling our codebase for additional zip codes and integrating our software with the physical infrastructure for high volume filling robots and printers.

    You are an ideal candidate if you:

    • Are familiar or excited to learn/code with several programming languages and web frameworks like Ruby on Rails, Javascript, React, React Native, Go, or Python.

    • Thrive in a dynamic fast-paced environment where you own products from start to finish, and make decisions quickly and independently. You may break things, but you fix them with speed.

    • Have 5+ years of experience writing production code.

    • Believe in Alto’s mission and our company values: Patients Come First, Leave No Patient Behind, Start with Empathy, Focus on Impact, Think Rigorously, and Be Humble.

    Want more insight into what motivates us to save patient lives? Hear it firsthand from our Tech Lead, Amir:

    Interviewing with Alto:

    • Phone screen with short coding challenge via CoderPad

    • Remote coding assignment (2 hours) followed by a code review discussion

    • Onsite

    Our current Engineering and Product Team:


    • Jamie Karraker, CTO/Co-Founder (former Parse/Facebook eng)
    • Monica Tran, VP of Product (former Product Lead at Khan Academy and Apple)

    Software Engineers:

    • Amir Ghazvinian, Engineer (former CoFounder of Exec & Interstate Analytics, both went through YC)
    • Damien Kan, Engineer (former CEO of Shogun
    • Elnaz Mosheghian (former Lob)
    • Joey Baker, Engineer (former Getable)
    • Alex Toombs, Engineer (former Apcera)
    • Sierra Brown, Engineer (former 23andMe)
    • Le Qi, Engineer (former GE)
    • Tom Cahill, Engineer (former Apcera)
    • Michael Riess, Engineer (former Lumity)
    • Brian McRae, Engineer (former Genentech)
    • Andy Lau, Engineer (former Infer)
    • Trevor Borg, Engineer (former 4C Insights)

    Product Designers:

    • Katie Rinkevich, Designer (former Optimizely and Etsy)
    • Jon Saquing, Designer (former Optimizely)
    • Omar Jalalzada, Product Designer (former Coatue Management)

    Tech stack

    Ruby on Rails, Go, React Native, Javascript, React


    Compensation and retirement


    Health and wellness

    Health insurance
    Dental insurance
    Vision insurance
    Life insurance
    Disability insurance

    Values and quality of life

    Catered lunches
    Alto - We work in SF's historic Dogpatch District
    Alto - Alto operates our very own pharmacy onsite!
    Alto - We're a fun loving group!
    Alto - We work hard to always put our patients first.
    Alto - We love our jobs (and laugh a lot)!
    Alto - You can walk into our pharmacy onsite
    Alto - Or get your prescriptions sent to us (by your doctor or transferred yourself), then delivered to you for free!
    Alto - We're growing at Alto...
    Alto - Our small, diverse, and goofy Product Team (missing a few) at our 3rd HackRanch weekend!
    Alto - Alto hits 100 employees! Nov 2017