Engineering and Product at Alto

Alto offers medication delivery and builds an advanced technology platform to help patients better manage and understand their medication therapy – all without any service or delivery fees. We provide the convenience of delivery, investigate savings for our patients, and allow patients to communicate directly with pharmacists.

Job Openings at Alto

Top Engineering Values

Each team is asked to select, explain, and rank their top 8 values in order of importance.
  • Customer Comes First

    Enabling a better patient experience is weaved into everything we do at Alto.

    “The customer comes first” is our #1 guiding principle. Everyone at Alto is genuinely passionate about our mission to create the most patient-centric pharmacy in the world, whether that be improving a patient’s day or improving their life. There are 125,000 deaths every year due to patients not taking their medications properly – those are 125,000 avoidable deaths. The current system is broken and getting your prescription medication is difficult and confusing: prior authorizations, renewals, high copays for drugs not covered by your insurance, travel to the brick-and-mortar pharmacy, and long lines or closed pharmacies. Alto removes the pain points to create a process that is now simple, friendly, and fully transparent. Given the statistics and adherence rates, Alto has saved an estimated 45 lives and we’re determined to save thousands more. If any of this resonates with you, please let us know. We'd love to hear from you!

  • Actively Practices Inclusion

    We’ve prioritized diversity and inclusion from the start.

    Alto focuses tremendous energy on diversity and inclusion, both in hiring and in our day-to-day practices. An exceptionally talented engineer who nails our interviews won’t make the cut if s/he doesn’t also share and embody our values. We make sure every candidate speaks with at least two female interviewers and when discussing technical challenges with current team members, we strive to create an environment where everyone feels they can speak openly and without fear of judgment. Our company culture of transparency, compassion, and open-dialogue is something we’re set on maintaining as we grow, even in the face of competing hiring goals.

    Atlo values technical expertise and a strong programming skill set, but it’s almost more important that every member on our team also embodies humility and compassion. After all, our patients face the same problems regardless of their race, ethnicity, religion, age, sexual orientation, or gender. As you can imagine, a problem facing a diverse population requires an equally diverse team to solve it. We can’t overstate how highly we prioritize our commitment to inclusivity.

  • Engages with Community

    A common thread through all of us is a desire to make a tangible impact on real people.

    At Alto, we have an overarching desire to “help the world,” and tackle an outrageously high medication non-adherence rate (the rate at which people don’t take their medication properly, or at all). However, we are largely motivated and inspired by connecting with the individuals we’re trying to help. That’s why we take so much pride in our Yelp reviews, have a Slack bot that posts every survey response we get from a patient, and why once a month, we volunteer at the SF Marin Food Bank. We want to be in touch with and give back to our community, personally and face-to-face. This is the common denominator across all members at Alto; we bond with one another as a result of bonding with our community, even when that means repackaging 3,000 pounds of cashews at the Food Bank.

  • Cross-Department Collaboration

    We’re deliberate in integrating all of the different orgs because our solution depends on collaboration. We’re constantly talking with one another.

    Once a week, we have a "Tea Time" meeting to review recent incident reports from our patients. This meeting always includes members from pharmacy, patient care, pharmacy operations, engineering, and design because we believe in a cross-functional approach to resolve the underlying issue(s) for any unhappy patient. Together, we figure out why these problems happened and what we can do to prevent them in the future.

    The problem Alto is solving is so complex that it requires the skill sets of a very broad team. Engineers need to work with pharmacists, designers need to work with our operations team, and the people who manage our partnerships with physicians and insurance providers need to be on the same page, too. Engineers, pharmacists, and operations sit together, lunch together, and we’re constantly talking.

  • Fast-Paced Environment

    Scrappiness and urgency are two of our company values.

    Our team members have had previous experiences working at or founding startups, so we’re well aware that “fast-paced environment” has become a euphemism for “it’s crazy." Yes, the excitement and energy that make startup culture so special is certainly alive and well at Alto, but what we really mean by “fast-paced” is that you will be expected to contribute a lot and very quickly. We’ve built different products in a very short time with very few people, and we’re constantly pushing to ship new things. Alto thinks on the order of weeks, not months. As we grow our team, we’re looking for people who are energized by a sense of scrappiness and urgency.

    Alto started in a storage closet in 2015. Today, we serve tens of thousands of patients across multiple cities and multiple specialties, all made possible by this incredible team of over 400 and the technology platform we’ve built. We’ve come a long way since the beginning, but we also believe we are only just getting started.

  • Rapidly Growing Team

    We raised our Series D in February of 2020 and are on track to become a $1B unicorn.

    As a new Alto Engineer, you’ll help us expand beyond SoCal and build the systems to support multiple locations. If you’re a mobile developer, you can build our mobile app from scratch in React Native, making our customers’ on-the-go experience seamless. Whether you enjoy frontend, backend, or fullstack work, you can help us take a holistic look at our Fertility patient experience or build any feature(s) that improve our internal tooling. There is so much to do and so much that can be done when you work with people who share your passion. If you’re curious about who we are or where we’re going, check out this podcast with our CEO Mattieu.

    We started 2020 with 30 engineers and hope to hire 100 more by 2021. And if you’re interested in how you might fit into our Pharmaly, reach out!


  • Customer Comes First
  • Actively Practices Inclusion
  • Engages with Community
  • Cross-Department Collaboration
  • Fast-Paced Environment
  • Rapidly Growing Team

Company Properties

  • B2C
  • Technical Founder(s)

Team Members

  • 11 Designers
  • 6 Product Manager
  • 30 Software Engineers

Vacation Policy

Take time as you need it.

Tech Stack

React Native, React, Ruby on Rails, Go

Interview Process

(1) Recruiter screen. (2) Intro phone screen w/ coding challenge. (3) Onsite. (4) Offer.