University of Iowa Health Care Software Engineer Interview Guide

The 60-second brief

A Software Engineer at University of Iowa Health Care plays a vital role in developing and maintaining software solutions that enhance patient care and operational efficiency. This position is crucial in a healthcare environment that relies heavily on technology to manage patient data, streamline processes, and implement innovative solutions to complex healthcare challenges. You will contribute to various projects that impact both the clinical and administrative operations, ensuring that the software solutions are robust, secure, and user-friendly. In this role, you will work collaboratively with multidisciplinary teams, including healthcare professionals and IT specialists, to design and implement systems that support real-time data access, patient management, and clinical decision-making.

This guide is scoped to a Software Engineer candidate at University of Iowa Health Care.

Focus areas

• Software Engineering (General)
• Soft Skills for Software Engineers
• Behavioral Interviewing

The University of Iowa Health Care interview process

University of Iowa Health Care candidates report 4 rounds over 3-5 weeks. The stages below are what candidates describe, not a published process.

Initial Screening

Candidates undergo an initial screening to assess basic qualifications and fit for the role.

What to demonstrate

• Candidates undergo an initial screening to assess basic qualifications and fit for the role
• Depth in Software Engineering (General)

How to prepare

• Be able to walk your CV end to end in two minutes, and say why this company specifically.
• Have your salary expectations, notice period and location constraints ready, and ask for the rest of the loop in writing.

Interviews with Stakeholders

Candidates participate in interviews with multiple stakeholders, including technical leads and management.

What to demonstrate

• Candidates participate in interviews with multiple stakeholders
• Including technical leads and management

How to prepare

• Answer aloud and timed: How do you prioritize competing deadlines?
• Answer aloud and timed: Can you explain the software development lifecycle and your experience with it?

Behavioral and Technical Questions

Expect a mix of behavioral and technical questions that assess interpersonal skills and technical expertise.

What to demonstrate

• Expect a mix of behavioral and technical questions that assess interpersonal skills and technical expertise
• Depth in Software Engineering (General)

How to prepare

• Prepare three examples from your own work, each with a decision you made and an outcome you can quantify.
• Re-read the description of the behavioral and technical questions above and write down what you would ask to confirm before it.

Collaborative Assessments

Interviews are designed to be collaborative and conversational, focusing on problem-solving and teamwork.

What to demonstrate

• Interviews are designed to be collaborative and conversational
• Focusing on problem-solving and teamwork

How to prepare

• Answer aloud and timed: How would you approach debugging a software issue that impacts end-users?
• Answer aloud and timed: Provide an example of a project where you had to think creatively to solve a technical challenge.

Where candidates lose points

Understand the healthcare landscape

Familiarize yourself with current trends and challenges in healthcare technology to demonstrate your awareness and commitment to the field.

Practice coding problems

Utilize platforms like LeetCode or HackerRank to sharpen your coding skills and prepare for technical assessments.

Prepare examples

Have specific examples ready to illustrate your problem-solving abilities and teamwork in past roles.

Know your resume

Be ready to discuss your experiences in detail, including the technologies you have used and the impact of your work.

Questions & practice

Write a function to reverse a string in your preferred programming language.

Medium · Coding Questions

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?

Given a data structure, how would you implement a specific algorithm?

Medium · Coding Questions

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?

Merge partitioned event streams into one ordered feed with bounded lateness

Hard · k-way merge · watermarks · out-of-order streams

The read-model service consumes 64 log partitions carrying about 4,000 events per second in total. Each partition is ordered within itself, but partitions drift by up to 30 seconds, and the activity feed must present a tenant's events in occurred_at order. Produce the merge. State its complexity, the buffer it requires in events and in bytes, what happens when one partition is idle, and what you do with an event that arrives after you have already emitted its position. Payloads average 1 KB.

Approach

1. Merge with a min-heap over the 64 partition heads keyed on (occurred_at, event_id): O(log P) per event and O(n log P) overall. The tie-break on event_id is what makes the output deterministic when two partitions carry the same millisecond, which matters because the feed is paginated and a non-deterministic order reorders pages under the reader.
2. Emitting the heap head is only correct once every partition has produced everything up to that timestamp, so the emit condition is a watermark: the minimum across partitions of the highest occurred_at seen, less the allowed lateness. Events are held until the watermark passes them, which is what turns individually ordered streams into a jointly ordered one.
3. Size the buffer from the lateness rather than guessing: 4,000 events per second times 30 seconds is 120,000 buffered events, and at 1 KB each about 120 MB of heap. That number is the real price of the ordering guarantee and belongs in front of whoever asked for it.
4. Handle the idle partition explicitly, because it fails the feed rather than corrupting it: a partition with no traffic never advances its own maximum, so the watermark freezes and output stops entirely. Either every partition emits a periodic idle marker carrying the broker's current time, or the watermark falls back to wall clock for a partition silent beyond a threshold.

Follow-up

• The lateness budget is raised to five minutes. What is the new buffer, and what besides memory changes?
• The consumer restarts. Where does it resume from, and what does the feed look like for the first 30 seconds?

How would you optimize a database query for performance?

Medium · Coding Questions

Approach

1. Name the grain you start from and join outward from it.
2. Check whether any join is one-to-many before aggregating, or the sums inflate.
3. Say which index the query would use, and what makes it unusable.
4. Handle the rows that do not match: that is usually the actual question.

Follow-up

• How does the query change if that join becomes one-to-many?
• What happens to this when the table is ten times larger?

Hold a per-tenant active cap against concurrent creates

Hard · write skew · isolation levels · constraints

A tenant on the standard plan may hold at most 50 resources with status='active'. The create handler runs SELECT count(*) FROM resource WHERE tenant_id = $1 AND status = 'active', compares to 50, then inserts. Two creates arrive 3 ms apart on different instances and the tenant lands at 51. Name the anomaly, say whether PostgreSQL 16 READ COMMITTED or REPEATABLE READ prevents it and why, then give an implementation that holds the cap at READ COMMITTED with the exact statements. Finally, say what changes when the cap is 'at most one running export per tenant' on job_run.

Approach

1. Name it: write skew. The two transactions read an overlapping set and write disjoint rows, so there is no row-level conflict for the engine to detect and each commit is individually legal.
2. Rule out the levels precisely. READ COMMITTED takes a fresh snapshot per statement and takes no lock on the counted rows, so both see 49. PostgreSQL's REPEATABLE READ is snapshot isolation: it removes non-repeatable reads and phantoms within the snapshot but still admits write skew, because the anomaly is not a re-read of a changed row, it is a read of a set that a concurrent transaction invalidates. Only SERIALIZABLE closes it, by tracking the read dependency and aborting one transaction with SQLSTATE 40001 — a guarantee that exists only if the application re-runs the whole transaction from the read.
3. Convert the set predicate into a single-row conflict: keep tenant.active_resource_count and run UPDATE tenant SET active_resource_count = active_resource_count + 1 WHERE tenant_id = $1 AND active_resource_count < 50 in the same transaction as the INSERT. Zero affected rows is the cap, returned as 409. The row lock serialises the decision at any isolation level, and contention is bounded to one tenant's row — which is also the fair-scheduling unit, unlike a global counter that would convoy every tenant behind one row.
4. State the cost you just took on: a counter is a second source of truth that can drift, so every path that changes status must adjust it inside the same transaction, and a periodic reconciliation has to exist, with resource_revision as the authority for what the count should have been.

Follow-up

• A resource moves from archived back to active. Which statements change, and what breaks if the counter update and the status change land in different transactions?
• The cap becomes plan-dependent and a plan can change mid-month. Where does the number 50 live, and who reads it?

What programming languages are you proficient in, and how have you applied them in past projects?

Medium · Technical Questions

Approach

1. Clarify what is being asked and what a complete answer contains.
2. State your assumptions explicitly before working the problem.
3. Say what you would check first and why it is the highest-information step.
4. Work from the requirement backwards to the design.

Follow-up

• What assumption would you test first?
• How would you know your answer was wrong?

Describe a technical problem you encountered and how you resolved it.

Medium · Technical Questions

Approach

1. Clarify what is being asked and what a complete answer contains.
2. State your assumptions explicitly before working the problem.
3. Say what you would check first and why it is the highest-information step.
4. Work from the requirement backwards to the design.

Follow-up

• What assumption would you test first?
• How would you know your answer was wrong?

Provide an example of a project where you had to think creatively to solve a technical challenge.

Medium · Problem-Solving Questions

Approach

1. Clarify what is being asked and what a complete answer contains.
2. State your assumptions explicitly before working the problem.
3. Say what you would check first and why it is the highest-information step.
4. Work from the requirement backwards to the design.

Follow-up

• What assumption would you test first?
• How would you know your answer was wrong?

How do you ensure the quality and reliability of your code?

Medium · Problem-Solving Questions

Approach

1. Clarify what is being asked and what a complete answer contains.
2. State your assumptions explicitly before working the problem.
3. Say what you would check first and why it is the highest-information step.
4. Work from the requirement backwards to the design.

Follow-up

• What assumption would you test first?
• How would you know your answer was wrong?

How would you approach debugging a software issue that impacts end-users?

Medium · Problem-Solving Questions

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 rounds and topics University of Iowa Health Care candidates report.

Day 1 — Map the University of Iowa Health Care loop

• Write out the reported sequence: Initial Screening, Interviews with Stakeholders, Behavioral and Technical Questions, Collaborative Assessments.
• For each round, write one sentence on what it is judging, from the description above, and mark the one you are least ready for.

Deliverable: A one-page map of the 4 reported rounds, with the weakest marked.

Day 2 — Work Software Engineering (General)

• Spend the session on Software Engineering (General), which University of Iowa Health Care candidates report being tested on.
• Write one worked example in Software Engineering (General) and time yourself on it.

Deliverable: One timed worked example in Software Engineering (General).

Day 3 — Work Soft Skills for Software Engineers

• Spend the session on Soft Skills for Software Engineers, which University of Iowa Health Care candidates report being tested on.
• Write one worked example in Soft Skills for Software Engineers and time yourself on it.

Deliverable: One timed worked example in Soft Skills for Software Engineers.

Day 4 — Work Behavioral Interviewing

• Spend the session on Behavioral Interviewing, which University of Iowa Health Care candidates report being tested on.
• Write one worked example in Behavioral Interviewing and time yourself on it.

Deliverable: One timed worked example in Behavioral Interviewing.

Day 5 — Answer out loud: Behavioral Questions

• Answer aloud, timed: Describe a time you faced a significant challenge at work. How did you handle it?
• Answer aloud, timed: What are your greatest strengths and weaknesses?

Deliverable: Spoken answers to 2 reported Behavioral Questions question(s), under time.

Day 6 — Answer out loud: Technical Questions

• Answer aloud, timed: Can you explain the software development lifecycle and your experience with it?
• Answer aloud, timed: What programming languages are you proficient in, and how have you applied them in past projects?

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

Day 7 — Answer out loud: Problem-Solving Questions

• Answer aloud, timed: How would you approach debugging a software issue that impacts end-users?
• Answer aloud, timed: Provide an example of a project where you had to think creatively to solve a technical challenge.

Deliverable: Spoken answers to 2 reported Problem-Solving Questions question(s), under time.

Behavioural preparation

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

Describe a time you faced a significant challenge at work. How did you handle it?

Medium · Behavioral Questions

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?

What are your greatest strengths and weaknesses?

Medium · Behavioral Questions

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?

How do you prioritize competing deadlines?

Medium · Behavioral Questions

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?

Can you explain the software development lifecycle and your experience with it?

Medium · Technical Questions

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?