Systems Engineer II, Healthcare IT

Healthcare IT powers technology delivery across One Medical's nationwide clinic network and Amazon Pharmacy's fulfillment operations. Our team owns the engineering, deployment, management, patching, and support of healthcare endpoints once they reach the field, ensuring clinicians and pharmacy staff have reliable, secure technology that stays out of their way so they can focus on patients. As a Systems Engineer on the Healthcare IT team, you will own the operational health of a fleet of over 7,000 endpoints spanning Windows, macOS, iOS, and Android across hundreds of clinic and fulfillment center locations. You will use technology to solve difficult operational problems: keeping devices patched, compliant, and performant at scale, root-causing failures across endpoint, identity, and network systems, and building the automation that lets a talented team operate a large fleet. You will serve as tier 3 support for on-site technology teams, owning the escalation path for complex endpoint infrastructure issues that require deep technical investigation. This is a hands-on operational engineering role. You will identify the patterns behind recurring device failures and automate them away, script fleet-wide configuration and patching changes, build monitoring that surfaces device health and compliance across the fleet, and drive operational excellence initiatives that produce measurable results. You will make trade-offs between time, resources, and operational burden, and you will resolve, mitigate, or escalate security and reliability risks with sound judgment. Healthcare IT is a fast-paced environment where priorities shift as the business grows. You will work across multiple technology domains (endpoint management, identity, networking, cloud infrastructure) and must be comfortable context-switching between project execution and operational support. On-Call Responsibility: This position involves on-call responsibilities for high-severity events related to critical endpoint infrastructure and identity systems. We invest in fault-tolerant design and root-cause resolution to minimize pages. When we do get paged, we work together to fix the underlying issue so it does not recur. Key job responsibilities - Own the operational health, availability, and performance of a fleet of over 7,000 healthcare endpoints (Windows, macOS, iOS, Android) - Build reusable automation and tooling that scales fleet operations: device provisioning, patching, compliance enforcement, and configuration management - Serve as an excellent diagnostician: interpret logs, understand dependencies, and root-cause failures across endpoint, identity, and network systems - Provide tier 3 support for production healthcare endpoint infrastructure, resolving complex escalations from field teams - Integrate device management platforms (MDM), identity providers (Active Directory, SAML/SSO), and operational tooling through scripting and APIs - Identify and remediate operational and security risks across the fleet; participate in security compliance reviews and vulnerability management - Build monitoring, alerting, dashboards, and metrics reporting for device health, patch compliance, login latency, and fleet-wide anomalies - Support specialized device fleet infrastructure including image tuning, patching, and monitoring - Drive operational excellence initiatives that demonstrate measurable improvements in reliability, compliance, or support burden - Create and review SOPs, runbooks, and operational documentation; drive engineering and operational best practices - Participate in a 24x7 on-call rotation for critical infrastructure services