---
title: 'Senior Cloud Infrastructure Engineer (Remote US) at Smile Digital Health'
canonical: 'https://feeny.ai/job/senior-cloud-infrastructure-engineer-remote-us-smile-digital-health-united-gsns6dc1vvtq'
type: 'job'
last_seen: '2026-11-06'
---

# Senior Cloud Infrastructure Engineer (Remote US) at Smile Digital Health

- **Company:** Smile Digital Health
- **Location:** United States
- **Compensation:** $120k–$135k
- **Employment:** full-time
- **Work type:** remote
- **Posted:** 2026-08-10
- **Last confirmed live:** 2026-11-06
- **Apply:** https://jobs.lever.co/smiledigitalhealth/253dea8e-0d0b-428d-9235-cd09b66cdd4a

## Job description

Working for a company like Smile Digital Health means supporting our mandate for #BetterGlobalHealth. We strive towards this goal every day, and the results can be seen in the impact of our innovative health data platform and data management solutions, which are used in over 20 countries. We were #19 on Deloitte's Technology Fast 50 Ranking for 2024!

Smile Digital Health makes it easy for healthcare stakeholders to collect and exchange data with our leading FHIR-based data liberation platform.

At its heart, the Smile platform enables people and organizations to better manage healthcare data. We help generate and liberate structured healthcare data to ensure effective delivery across care teams and health systems bringing  #BetterGlobalHealth to patients everyday!

Apply today and find plenty of reasons to SMILE!

The Senior Cloud Infrastructure Engineer is responsible for designing, building and maintaining cloud hosted services and platforms to support Smile Digital Health’s SaaS and offering. This includes, but not limited to, owning the development and maintenance of deployment artifacts such as HELM charts, docker container/ compose configurations, infrastructure as code and build/deployment/automation pipelines. The role works closely with platform, infrastructure, architecture and security teams to ensure cloud deployments are scalable, reliable, secure and aligned with enterprise architecture patterns.

Reponsibilities:

- Develop, test, and maintain cloud-native RESTful APIs using Python, GoLang/ Go  and JavaScript/TypeScript.
- Build and manage Docker container images, ensuring best practices for image build, security, cost efficiency and deployments.
- Author, maintain, and version HELM charts for deploying services into Kubernetes/ Openshift Environment, including configuration/ annotation values, templates, upgrades and rollback support.
- Participate in (or build) CI/CD pipelines to automate deployment, testing, monitoring, and roll-back of SaaS services.
- Monitor the performance, reliability, and scaling behavior of services; identify bottlenecks and implement solutions (caching, concurrency, resource limits, horizontal auto-scaling).
- Develop and maintain serverless SaaS components using AWS CDK, Lambda, API Gateway, and ECS/Fargate.
- Ensure high availability and fault tolerance through Kubernetes features such as readiness and liveness probes, sensible resource requests/limits, and proper namespace/networking isolation.  Implement and enhance CI/CD pipelines with automated testing, versioning, and documentation publishing.
- Implement and enhance CI/CD pipelines with automated testing, versioning, and documentation publishing.
- Manage in-cluster dependencies such as PostgreSQL, Kafka, Grafana, and ElasticSearch using Helm or Operators.
- Collaborate with security, operations, and infrastructure teams to ensure deployments meet security, compliance, logging, monitoring, and auditing requirements.
- Troubleshoot and debug issues in production and staging environments. Provide root cause analysis and propose corrective measures.
- Maintain clear documentation of architecture, deployment procedures, configuration, and usage of cloud tools.

Requirements:

- 7+ years of professional experience in cloud development or infrastructure engineering roles.
- Bachelor’s degree in Computer Science, Software Engineering, or a related discipline (or equivalent work experience).
- Proven experience working to design and build SaaS applications and multi-cloud solutions.
- Understanding of DevOps and hands-on experience working with DevOps tooling including, but not limited to, Gitlab CI, GitHub Actions, Azure Devops etc.
- Working knowledge of public cloud SDKs/APIs (Azure SDK, AWS SDK, GCP SDK, etc.) for interacting with provider services (storage, identity, secrets, etc.). Boto3 and AWS CDK preferred.
- Strong experience building APIs (REST or GraphQL) in Python and/or JavaScript/ TypeScript.
- Solid knowledge of Docker, containerization best practices, and experience deploying containers in Kubernetes and OpenShift.
- Experience authoring and maintaining Helm charts and Operators for complex deployments.
- Familiarity with monitoring/logging/tracing tools (e.g., Prometheus, Grafana, OpenTelemetry, Elasticsearch/Loki, etc.).
- Strong understanding of cloud hosting (AWS and Azure preferred) and cloud storage, secrets, and security services.
- Familiarity with GitOps tooling and principles.
- Working experience with Hashicorp Terraform to build and deploy complex environments.
- Ability to work in cross-functional teams and communicate effectively, both written and verbal.
- Self-motivated, detail-oriented, with strong problem solving and troubleshooting skills

Additional Information:

- Smile discloses that artificial intelligence (AI) may be used in portions of the recruitment and selection process, such as resume screening or application assessment. All hiring decisions are ultimately made by qualified human decision-makers, and AI tools are used to support - not replace - fair and equitable hiring practices.
- This position is a new role, created to support Smile’s continued growth and commitment to operational excellence.

Some of the benefits we offer:

- Remote Work Environment
- Flexible Time Away From Work Policy including PTO, Personal and Sick Days
- Competitive Salary and Health/Medical Benefits
- RRSP/TFSA/401K Employee Contribution
- Life and Disability
- Employee Assistance Program
- FHIR Study Program and Skillsoft Learning
- Super HAPI Fun Club

Smile's core values include respect, inclusion, embracing our differences, and celebrating shared values because our people are the foundation of our success. We are big on creating a sense of belonging and empowering each other to bring our authentic selves to work.  We are dedicated to fostering a workplace that values diversity, equity, and inclusion.

We welcome and encourage candidates of all backgrounds to apply. Candidates are encouraged to inform us if they wish to discuss or require accommodations during interviews or while working at Smile.

## About Smile Digital Health

## Company Overview
- **One-liner**: Smile Digital Health provides a FHIR-native health data platform that unifies fragmented healthcare data for governments, health systems, and providers.
- **Entity Type**: Private (Series B)
- **Headquarters**: Toronto, Ontario, Canada (US office in Austin, Texas)
- **Founded**: 2016
- **Founders**: James Agnew, Duncan Weatherston

## Core Business
- Primary industry: Healthcare IT / Health Data Interoperability
- Target customers: Governments, health systems, healthcare providers, researchers, app developers (B2B, Enterprise)
- Mission: "Reduce barriers between information and care, and accelerate delivery of high-quality care" — guided by the tagline #BetterGlobalHealth

## Products & Services
- **[Smile CDR]**: The world’s first FHIR-based clinical data repository (CDR) as a service. A high-performance, secure platform supporting multiple FHIR versions, HL7v2, custom ETL, federated identity, terminology services, and Smart on FHIR. Deployable on cloud or on-premises.
- **Health Data Fabric**: A comprehensive, FHIR-native platform enabling interoperability, digital quality measures, and clinical intelligence across enterprise data sources.
- **HAPI FHIR Maintenance**: Smile Digital Health is the primary maintainer of the HAPI FHIR open-source reference implementation, giving them deep influence over FHIR standards worldwide.

## Market Standing
- **Valuation/Market Cap**: Not publicly available
- **Key Metric**: Annual revenue of $15.4M; Total funding of $65M
- **Notable Investors/Partners**: UPMC Enterprises (led Series A and Series B), FirePower Capital (debt financing)
- **Growth Signals**: 190+ global implementations, 30+ US payer compliance deploys, touching 110M+ American lives; headcount grew 2.3% YoY to ~201 employees across 7 countries (Canada, US, India, Philippines, New Zealand); contributed to 33+ HL7 working groups

## Competitive Advantages
- Deep expertise: Core team has 40+ years of enterprise-class systems experience, specifically in healthcare integration (HAPI, e-prescriptions).
- Open-source leadership: Maintainer of HAPI FHIR, the dominant open-source FHIR implementation worldwide — gives them unmatched influence over FHIR standards.
- Security & compliance focus: Holds rigorous security certifications and voluntarily undergoes multiple audits; data stewardship and privacy are top priorities.
- Human-in-the-loop AI approach: Deploys deterministic AI models and clinically verifiable information with full audit trails, differentiating from probabilistic models.
- Multi-version FHIR support & federated identity: Flexibility for both jurisdictional and organizational settings, supporting a wide range of deployment scenarios.

## Strategic Focus
- Continuing to build out the FHIR-native "Health Data Fabric" to enable AI-driven innovation, intelligent automation, and scalable outcomes for global healthcare.
- Scaling interoperable data infrastructures that are "complete, computable, and validated" to support clinical quality measures and AI.
- Expanding global presence (currently active in Canada, US, India, Philippines, New Zealand) with a remote-first culture, focusing on hiring across Canada and the US.

## Why Work Here
- **Remote-first culture**: Work from home, co-working spaces, or anywhere you feel inspired; meaningful in-person team meetups also happen.
- **Flexibility & autonomy**: Generous, flexible PTO; ability to set your own schedule.
- **Global, mission-driven team**: 201 employees across 7 countries working on transforming healthcare data — work that directly impacts 110M+ American lives.
- **Inclusive values**: Core values of respect, inclusion, and celebrating individuality; commitment to diverse teams and belonging.
- **Benefits**: Comprehensive physical, emotional, and mental well-being benefits including mental health resources, short/long-term disability, life insurance.
- **Growth & development**: On-the-job learning, certification opportunities, and embedded professional development.
- **Open positions**: Technical Manager (Implementations & Delivery), Technical Account Manager, Senior Performance Tester, Senior Agile Lead, Support Engineer L2, Senior Software Developer (Support), Account Executive, Senior Cloud Architect, Senior Cloud Engineer — all remote US or remote Canada.

## Sources
1. [smiledigitalhealth.com](https://www.smiledigitalhealth.com/about-us)
2. [linkedin.com](https://linkedin.com/company/smile-cdr)
3. [smiledigitalhealth.com](https://www.smiledigitalhealth.com/careers)
4. [jobs.lever.co](https://jobs.lever.co/smiledigitalhealth)
5. [indeed.com](https://www.indeed.com/cmp/Smile-Digital-Health)

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