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Heidi Health Software Engineer Interview Guide

Heidi Health Software Engineer interview guide: reported rounds, questions and how candidates describe the process.

The 60-second brief

As a Software Engineer at Heidi Health, you are at the forefront of transforming clinical documentation and patient-provider interactions. You will build and scale the intelligent infrastructure that allows clinicians to focus on care rather than administrative burdens. This role is inherently cross-functional, requiring you to bridge the gap between complex medical workflows and elegant, intuitive software solutions. You will contribute to a product suite that is rapidly evolving, meaning you must be comfortable with ambiguity and high-impact engineering. Whether you are optimizing backend data pipelines or enhancing the core user experience, your work directly impacts the quality of healthcare delivery. Success here requires a blend of technical rigor, a deep sense of empathy for the end-user, and the ability to operate effectively in a fast-paced, mission-driven environment.

This guide is scoped to a Software Engineer candidate at Heidi Health.

Focus areas

  • STAR format (Situation, Task, Action, Result)
  • Live coding exercises
  • Situational/behavioral interview questions

Where to focus your preparation

No round sequence has been reported for Heidi Health. Confirm the format with your recruiter.

Preparation focus

No round sequence has been reported for this company, so confirm the format with your recruiter and work the reported questions below.

What to demonstrate

  • Breadth across the topics this company reports testing
  • Whether you confirm the format before preparing for it

How to prepare

  • Ask the recruiter for the sequence, the duration of each stage and whether you will be writing code
  • Work the reported questions below and time yourself

Where candidates lose points

Clarify early

If a question is ambiguous, ask clarifying questions before jumping into a solution. This is a sign of a senior-level engineer.

Be proactive

If you complete a take-home test, ensure it is production-ready. Do not submit "quick and dirty" code.

Document your journey

Keep a log of the people you speak with and the questions you are asked. This will help you identify patterns and stay organized.

Value the mission

Heidi Health is focused on reducing clinician burnout. Showing that you understand and care about this problem will set you apart.

Questions & practice

Walk me through a complex technical challenge you solved in a previous role.

Medium · Technical and Coding Proficiency

Approach

  1. Restate the input: its shape, its size, and what is guaranteed about it.
  2. Name the brute-force solution and its complexity before improving on it.
  3. Choose the data structure from the access pattern, not from familiarity.
  4. State the target complexity and say which constraint rules the naive version out.

Follow-up

  • How does this change if the input no longer fits in memory?
  • What is the worst case, and how likely is it on real data?

Can you explain the trade-offs between different data structures for [specific use case]?

Medium · Technical and Coding Proficiency

Approach

  1. Restate the input: its shape, its size, and what is guaranteed about it.
  2. Name the brute-force solution and its complexity before improving on it.
  3. Choose the data structure from the access pattern, not from familiarity.
  4. State the target complexity and say which constraint rules the naive version out.

Follow-up

  • How does this change if the input no longer fits in memory?
  • What is the worst case, and how likely is it on real data?

How do you ensure your code remains performant as user volume scales?

Medium · Technical and Coding Proficiency

Approach

  1. Restate the input: its shape, its size, and what is guaranteed about it.
  2. Name the brute-force solution and its complexity before improving on it.
  3. Choose the data structure from the access pattern, not from familiarity.
  4. State the target complexity and say which constraint rules the naive version out.

Follow-up

  • How does this change if the input no longer fits in memory?
  • What is the worst case, and how likely is it on real data?

Explain why the owner filter ignores the listing index

Medium · composite index · query plans · sort elimination

The only index on resource is (tenant_id, status, updated_at DESC, resource_id DESC). A new endpoint returns one user's resources across all statuses, newest created first: WHERE tenant_id = $1 AND owner_user_id = $2 ORDER BY created_at DESC LIMIT 20. On a tenant with 2M rows it takes 900 ms and EXPLAIN shows a sort above a large scan. Explain precisely why the existing index cannot serve it, give the index that can, and state which of these the new index still will not help: owner_user_id alone across tenants; the same query ordered by updated_at. PostgreSQL 16.

Approach

  1. Separate the two jobs an index does. For filtering, a composite btree is seekable only on a left prefix, so with no predicate on status the scan can at best range over tenant_id and test owner_user_id per row; PostgreSQL 16 has no btree skip scan to jump the unconstrained column.
  2. For ordering, the index is sorted by (status, updated_at) within a tenant and not by created_at, so the LIMIT cannot stop early: every matching row is read and then sorted. That is the 'Sort Method: top-N heapsort' line, and it is why the plan reads 2M rows to answer with 20.
  3. Derive the replacement from the access path — equality, equality, then the ordering column: CREATE INDEX CONCURRENTLY ON resource (tenant_id, owner_user_id, created_at DESC). The scan seeks to the (tenant, owner) range and walks 20 entries in order, so the Sort node disappears along with the row-read.
  4. Treat INCLUDE (title, status) as conditional, not free. An index-only scan still visits the heap for any row whose page is not marked all-visible, so on a table taking 1.2k writes/second the win depends on autovacuum keeping the visibility map current, and the wider index costs more on every insert.

Follow-up

  • 90% of rows are status='active'. Would a partial index WHERE status = 'active' change your answer, and for which of the three queries?
  • A dashboard runs this for 40 owners in one page load. What changes about the design?

Stop tag and share joins from fanning out a page

Medium · join fan-out · semi-joins · many-to-many

resource_tag is (resource_id, tag_id) with PK (resource_id, tag_id); resource_share is (resource_id, shared_with_user_id, permission). The tagged-and-shared listing inner-joins resource to both, filters tenant_id, tag_id = ANY($2) and shared_with_user_id = $3, orders by updated_at DESC and takes 50. Pages come back with fewer than 50 distinct resources and the total in the header is far too high. Explain the row multiplication, rewrite both the page query and the count query so each is correct, and name the index each one needs. PostgreSQL 16.

Approach

  1. Do the arithmetic against the predicates that are actually there. An inner join emits one row per matching child row, and both joins are filtered: tag_id = ANY($2) admits only the requested tags, shared_with_user_id = $3 admits one user's share rows. So a resource holding three of the requested tags and shared with $3 once yields three rows, not one — the multiplier is its count of matching tags times its share rows for that single user, and that second factor is 1 unless the table admits duplicate (resource_id, shared_with_user_id) pairs. LIMIT 50 then limits rows rather than resources, and COUNT(*) counts pairs — the header is the product, not the population.
  2. Reject DISTINCT as the fix. It deduplicates after the product has been built, so the planner must materialise and sort the fanned-out set before the LIMIT can apply, and it leaves any SUM or AVG in the same select list wrong.
  3. Rewrite both filters as semi-joins, keeping resource as the only row source: AND EXISTS (SELECT 1 FROM resource_tag rt WHERE rt.resource_id = r.resource_id AND rt.tag_id = ANY($2)) and the same shape against resource_share. A semi-join stops at the first match per resource and preserves the driving index order, so ORDER BY updated_at DESC, resource_id DESC LIMIT 50 still stops after 50 rows.
  4. Count with the same predicates and no join at all: SELECT count(*) FROM resource r WHERE r.tenant_id = $1 AND r.status = 'active' AND EXISTS (...) AND EXISTS (...). Nothing multiplies a resource, so the number is the population.

Follow-up

  • The filter changes from 'any of these tags' to 'all of these tags'. Rewrite it and state what it costs relative to the ANY form.
  • A resource can be shared with the same user twice under different permissions. Does your count change, and should it?

Relay committed events to the log without gaps or reordering

Medium · transactional outbox · at-least-once · ordering

outbox_event rows are written in the same transaction as the state change and carry aggregate_type, aggregate_id, aggregate_version, payload and status, with a partial index on (created_at, event_id) WHERE status = 'pending'. The relay publishes about 4k events/second to a partitioned append-only log keyed by aggregate_id, with one leader per partition range holding a lease. Consumers must never miss an event; they may see one twice. Design the claim-publish-mark loop, and state exactly what consumers observe when a leader's lease expires while it is mid-batch.

Approach

  1. Claim with SELECT ... WHERE status='pending' ORDER BY created_at, event_id LIMIT $batch FOR UPDATE SKIP LOCKED inside a transaction. SKIP LOCKED lets several relay workers share a range without serialising on each other's rows, and the partial index keeps the claim proportional to the backlog rather than to a table that is overwhelmingly published rows. At 4k/second a batch of 500 is eight claims per second, each an index scan of 500 entries.
  2. Publish before marking, never the reverse, and say why it is a choice. Marking first loses the event outright if the process dies in the gap, and the loss is silent - nothing remains to retry, and it surfaces later as a projection missing a row. Publishing first can repeat the event, and repetition is what every consumer is already built to survive. That single ordering is the whole at-least-once guarantee.
  3. Preserve the only ordering on offer. Partition by aggregate_id and never publish two events for one aggregate concurrently: claim in (created_at, event_id) order and publish sequentially within an aggregate, or hash aggregate_id to a worker slot. Order across aggregates is not available at any price here, which is why the event carries aggregate_version and the full fact rather than a delta - a consumer can then discard what it has already applied without coordinating with anyone.
  4. State the failover behaviour precisely, because it is the consistency-versus-availability decision in this design. A lease expires because the holder is slow, and no mechanism distinguishes that from dead, so for the length of the lease window two leaders can publish the same claimed batch. The system accepts duplicates to avoid stalling publication for every aggregate in the range whenever one worker pauses. Consumers deduplicate on (aggregate_id, aggregate_version) and drop anything at or below what they have applied.

Follow-up

  • The relay is down 40 minutes and 9.6 million rows are pending. What does catch-up do to the primary, and what changes in the claim loop to survive it?
  • A consumer insists it never received an event. Which single query settles whether the relay lost it, and what does each answer look like?

Keep one unresponsive destination from stalling all webhook delivery

Medium · fan-out · circuit breaker · timeouts

Egress delivery sends about 1.5k webhooks/second to 40k destinations, with a per-destination concurrency cap of 4 and a 10-second connect-plus-read timeout. One destination begins accepting connections and never responding; within the hour 150 destinations behave the same way. Design the delivery path so unrelated destinations are unaffected: the pool structure, the timeouts, the retry policy, the per-destination circuit, and what is recorded so a retry is not a second effect at the receiver. State how many in-flight slots the degraded destinations hold and why that number decides the design.

Approach

  1. Start with the number, and with the law that produces it. In-flight work is arrival rate times time in service, so 1.5k/second against a healthy 200 ms response needs about 300 concurrent slots. Per destination the same product applies, ceilinged by the concurrency cap: at the fleet average of 0.0375 deliveries/second per destination (1.5k spread over 40k) a 10-second timeout is 0.375 slots. A destination that has queued retries behind it is a different regime - every slot refills the instant an attempt expires, so it sits pinned at its cap of 4 - and 150 of those hold 600 slots, more than a pool sized for healthy traffic, entirely consumed by endpoints that will never answer. The per-destination cap bounds one endpoint and says nothing about the aggregate, which is exactly why it alone is not containment.
  2. Contain with bulkheads and an admission bound rather than a larger pool. Cap total in-flight per pool and shard destinations across pools by a hash of destination id, so a correlated group - one provider, one region - cannot exceed its pool's share. A delivery refused admission and re-queued with backoff is strictly better than one holding a slot on behalf of a receiver that is not listening.
  3. Treat the timeout as two timeouts, and be exact about what shortening one buys. Connect and read are separate failures and both must be shorter than the budget of whatever is waiting. Occupancy is min(cap, arrival rate x timeout), so dropping the read ceiling from 10 seconds to 3 cuts a merely slow destination's occupancy proportionally, 0.375 slots to 0.11 at the fleet average. It does not cut the 4 slots held by one of the 150: a destination with a retry backlog arrives far above cap/timeout - 0.4/second at a 10-second timeout, 1.33/second at 3 - so it stays pinned at the cap either way and only the slot-seconds per attempt fall. What that does buy is detection rate: 3.3x more failures observed per second on the same four slots, which is how fast the circuit reaches its threshold. Pick the value from the measured latency distribution of successful deliveries, with their high percentile as the floor, not from a round number.
  4. Add a circuit per destination, counting a timeout as a failure. Once open, fail fast without taking a slot - that is the whole point, converting 4 held slots into zero. Half-open on a schedule with exactly one probe and close only if the probe succeeds, so a permanently dead endpoint costs one request per interval instead of a growing retry queue.

Follow-up

  • The destination is not dead - it answers in 9.5 seconds with a 200. Does a failure-rate circuit open? Should anything shed that traffic, and on what signal?
  • One destination requires deliveries in order. What does a per-destination concurrency of 4 do to that guarantee, and what would you change to offer it?

How do you approach debugging a system when the root cause is not immediately apparent?

Medium · Technical and Coding Proficiency

Approach

  1. Establish what changed and when, before forming any theory.
  2. Pick a bisection that eliminates candidates whichever way it turns out.
  3. Check the instrumentation before believing the symptom.
  4. Separate the trigger from the cause; the deploy is rarely the bug.

Follow-up

  • What would you look at first, and what would it rule out?
  • How would you tell a cause from a coincidence here?

Suggested practice checklist

Built from the topics and questions Heidi Health candidates report; no round sequence has been reported.

Day 1 — Establish the Heidi Health format

  • No round sequence has been reported, so ask your recruiter for the sequence, the duration of each stage and whether you will write code.

Deliverable: A written reply from your recruiter confirming the format.

Day 2 — Work STAR format (Situation, Task, Action, Result)

  • Spend the session on STAR format (Situation, Task, Action, Result), which Heidi Health candidates report being tested on.
  • Write one worked example in STAR format (Situation, Task, Action, Result) and time yourself on it.

Deliverable: One timed worked example in STAR format (Situation, Task, Action, Result).

Day 3 — Work Live coding exercises

  • Spend the session on Live coding exercises, which Heidi Health candidates report being tested on.
  • Write one worked example in Live coding exercises and time yourself on it.

Deliverable: One timed worked example in Live coding exercises.

Day 4 — Work Situational/behavioral interview questions

  • Spend the session on Situational/behavioral interview questions, which Heidi Health candidates report being tested on.
  • Write one worked example in Situational/behavioral interview questions and time yourself on it.

Deliverable: One timed worked example in Situational/behavioral interview questions.

Day 5 — Answer out loud: Technical and Coding Proficiency

  • Answer aloud, timed: Walk me through a complex technical challenge you solved in a previous role.
  • Answer aloud, timed: How do you approach debugging a system when the root cause is not immediately apparent?

Deliverable: Spoken answers to 2 reported Technical and Coding Proficiency question(s), under time.

Day 6 — Answer out loud: Behavioral and Situational

  • Answer aloud, timed: Tell me about a time you had a conflict with a teammate regarding a technical decision. How did you resolve it?

Deliverable: Spoken answers to 1 reported Behavioral and Situational question(s), under time.

Day 7 — Dry run for Heidi Health

  • Run one full mock under time, then write down the two questions you most want to ask your interviewers.

Deliverable: A completed timed mock and two questions to ask.

Behavioural preparation

Behavioural rounds judge the decision you made and what it cost.

Tell me about a time you had a conflict with a teammate regarding a technical decision. How did you resolve it

Medium · Behavioral and Situational

Tell me about a time you had a conflict with a teammate regarding a technical decision. How did you resolve it?

Approach

  1. Pick a story where you made the decision, not one where you watched it.
  2. State the situation in two sentences and spend the rest on the reasoning.
  3. Give the blast radius: what could have broken, and what you measured.
  4. Name the disagreement and how you resolved it with evidence.

Follow-up

  • What would you do differently if you ran that again?
  • How did you know your change caused the improvement?

Reverse your own decision and price the reversal

Medium · reversibility · measurement · migrations

Describe a technical decision you made and later reversed. Pick one that cost something: a service you split and merged back, a cache you added and removed, an index you created that pushed the planner onto a worse plan, a projection you rebuilt from scratch. State what you believed when you decided, the measurement that changed your mind, how long the wrong version ran in production, and what the reversal cost in migrations, dual writes, and a deprecation window for callers you did not own.

Approach

  1. State the original rationale without irony, in the version you would still defend given what was known then. If it is not defensible, the story is about carelessness rather than judgement, and a different example serves you better.
  2. Give the measurement that moved with a before and after: the p99 that did not improve, the cache hit rate that sat at 40%, the plan that flipped to a sequential scan once the table passed a size you can name.
  3. Cost the reversal in steps, not adjectives: expand-and-contract deploys, the dual-write window, the callers who had to be notified, the rows already written in the wrong shape that had to be backfilled or abandoned.
  4. Distinguish reversal from rewrite by naming what you kept. Most good reversals preserve the schema or the interface and undo one decision inside it, which is also why they were affordable.

Follow-up

  • What in that decision was irreversible, and did you know it was irreversible when you made it?
  • How did you tell the people who had already built on top of the original decision?

Unblock an engineer without taking the keyboard

Easy · mentoring · leases · at-least-once

A teammate has spent two days on a job handler that occasionally writes duplicate rows. They are certain the queue is delivering twice by mistake. You suspect a lease expiring under a slow handler, so the job is running concurrently with itself. Describe how you have unblocked someone in this position: what you asked before offering a hypothesis, what you showed them rather than told them, and what you left them owning. Then say what you would do if their theory turned out to be the right one.

Approach

  1. Ask before diagnosing, and ask for things answerable from data they already have: the attempt count on the job rows that produced duplicates, the handler's observed duration against its lease expiry, and whether the duplicate rows share a natural key that a unique constraint could have caught.
  2. Teach the shape rather than the answer. A lease cannot distinguish a dead worker from a slow one, so a handler that outruns its lease is running twice by design, and deploys deliver the other half by killing handlers mid-run on every rollout. Both of their candidate theories produce identical duplicate rows, which is why the evidence has to come from timings rather than from argument.
  3. Hand over a checklist they execute: a natural key on every write the handler performs so the second copy collides rather than appends, the record of intent written before any external effect, a lease heartbeat while running, and the metric that shows it working.
  4. Keep ownership with them deliberately. Pair on the first write, then step back; if you finish it yourself you have closed one ticket and left the same person stuck on the next redelivery.

Follow-up

  • How would you distinguish a genuine double-delivery from a lease expiry using only the data already stored?
  • Their handler calls an external endpoint before recording that it did. What do you tell them to change first?