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Alto Pharmacy Technician

Alto Pharmacist

It’s official: Alto Pharmacy is a great place to work! We’re honored to join the community of Great Place to Work-Certified™ companies based on team member feedback and a rigorous assessment of our company’s culture and benefits.

Join us in delivering our industry-leading pharmacy care to millions of people across the country. As a member of the team, you’ll play an integral role in improving our customers’ quality of life and redefining what’s possible in pharmacy. 

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Our mission is to fulfill medicine’s true purpose — to improve quality of life — for everyone who needs it. That takes a dedicated team of mission-driven, value-minded people. Read on to figure out if Alto is the right career move for you.

Help Us Shape the Future of Healthcare

Working at Alto isn’t just a job. For every team member, from product designers to pharmacists to patient care gurus, Alto is a means to a fulfilling career focused on making a difference in the lives of people who rely on prescription medicine to lead healthy, happy lives. In the process, we’re also changing an industry that has long gone unchecked.

At the highest level, Alto is a pharmacy. But we are not a traditional pharmacy. Instead of operating dozens of small-volume distribution sites across a metro area like chain pharmacies, we own and operate high-volume pharmacy fulfillment centers staffed by small, highly efficient teams supported by proprietary technology. We have one fulfillment center per metro area that we serve, including San Francisco, Los Angeles, and Orange County, and a centralized operations facility in Denver. Out of our fulfillment centers, we process and fill prescription orders and deliver directly to patients’ homes or offices by way of our free, same-day courier service.

On top of the convenience and accessibility of same-day delivery, Alto has three product pillars that allow us to deliver an exceptional experience to our users: the Alto Patient app, Alto MD, and Wunderbar. Learn more about our products and our industry-disrupting business model.

Alto is the world’s most patient-centric pharmacy. Our goal is not simply to distribute prescription medications but to improve patients’ health outcomes and their quality of life and to make those improvements accessible to everybody.

To get to that point, we need to understand what’s preventing patients from accessing all the benefits medicine has to offer. We believe it’s especially important to address the high-level problem of non-adherence, which is when patients don’t take the medication they’re prescribed. It also means learning how to scale our technology and processes to bring our products to more people in current and new markets. To achieve both of these things, we need to first scale our team. Learn more about Alto’s potential for growth and plans for the future, and how our team contributes to our success.

Loving what you do starts with doing something you believe in. It’s enriched by working alongside people who share your goals in an environment conducive to your work style and aspirations. At the foundation of Alto’s culture is our mission; our core values like acting empathically, thinking rigorously, making impact, staying humble, and putting patients first; the diverse backgrounds of our team members; and the supportive but highly autonomous way we get work done. Learn more about the Alto’s values and culture through the eyes of our CTO and co-founder, Jamie Karraker.

If Alto sounds like an environment you would thrive in, we would love to hear from you! We’re always on the lookout for great people to fill in our product, design, engineering, analytics, people, recruiting, finance, sales, business operations, logistics, pharmacy, and patient care teams. Check out our open positions to see if there is an opportunity that’s right for you!

Are You Right for Alto?

Why Mission-Driven Software Engineers Hold the Key to Alto’s Continued Success

Alto is the world’s most people-centric pharmacy. Our goal is not simply to distribute medications but to improve health outcomes and quality of life. What’s more, we want to make those improvements accessible to everybody.

To get to that point, we need to understand what is preventing people from accessing all the benefits medicine has to offer. We believe it’s especially important to address non-adherence, which is when people don’t take medications as prescribed. Non-adherence is a national problem that causes 125,000 avoidable deaths per year (more than three times the number of car accident deaths) and $300 billion in avoidable medical costs (more than half the money spent on pharmacy as a whole).

It also means learning how to scale our technology and processes to bring our products to a bigger swath of the population. To achieve both of these things, we need to first scale our engineering team.

Because of our unique business model, Alto is positioned to pursue three exciting growth vectors:

New Therapeutic Specialties: In addition to our general pharmacy capabilities, we have developed specialized expertise and infrastructure for managing complex treatments like fertility, dermatology, HIV, psychiatry, and other therapies that come with sticky coordination issues and unique considerations. We have made it easier than ever for people to navigate these treatment areas, but there is more we can do. Our team has identified 26 additional treatment areas that could benefit from specialized technology and processes. Mastering those areas is high on our to-do list.

New Geographic Markets: By expanding into the top 50 U.S. cities, we could potentially serve 55% of the country’s population. If we expand to the top 100 cities, our coverage would increase to 70%.

New Clinical Partnerships: Alto facilitates coordination between our team, healthcare providers, insurance companies, and the people taking the medications. In the process, we improve workflows and health outcomes. That offers a powerful benefit to clinics, medical groups, and hospital systems. Because of that reputation, we currently have a waiting list of healthcare providers who want to partner with us. That’s more demand than we can keep up with, which isn’t such a terrible problem.

When Opportunity and Demand Exceed Capacity

Alto is in a fortunate position. It is rare among companies to have multiple compounding growth vectors and a reserve of would-be partners angling for our product. We are not demand constrained, we are operationally constrained, and even then, we continue to double our business every six to nine months — just not as quickly as our potential promises.

Scaling up as a means of reaching our potential is an exciting challenge we’re already tackling. In late 2018, we closed our Series C, giving us the fuel we need to build out our engineering team and develop the technology and processes that will make our continued growth possible. That work will entail fleshing out each of our existing product areas, scaling them, and identifying and solving even more deep-rooted industry issues through better technology and better processes.

Currently, Alto boasts a small but talented and agile engineering team staffed by individuals who honed their experience at some of the biggest names in tech like Facebook, Google, Uber, 23andMe, MIT, Stanford, and Berkeley. All of our engineers are relatively senior, so everyone has autonomy and ownership over their projects. It’s a collaborative, supportive, mission-driven environment, which is how we’ve been able to build so much in a relatively short period of time.

Up until now, we have been deliberate about keeping the team small, but we’ve reached an inflection point. In the next 18 months, we’re looking to increase the engineering team four-fold. With our new team in place, we will be in a great position to focus on our objectives: building and perfecting our operational efficiencies and product scalability.

We’re approaching the challenge of scalability from a few angles:

One is automation. We want to take the algorithms that are in our employees’ heads and put them into code, so they can focus more on caring for patients rather than logistics. We’ve done a bunch of automation work already, but there’s a lot left to do.

We’re also intent on designing tools to help our own team be more efficient with their time, which will mean better UX, better UI, more batching, and less context switching.

The third angle is self-service, and it’s the one we’re focused most intently on. Right now, there is significant human interaction between our team and consumers because we want to make sure consumers have the information they need to make optimal healthcare decisions. In our next phase of growth, we want to automate that process without losing any transparency or depriving a consumer of any agency, no matter their technological competence.

Essentially, we want to build the pharmacy version of TurboTax (without the part about lobbying to keep the system broken). With the right prompts and information, TurboTax walks users through the U.S. tax system, which is huge and complicated. In effect, the user becomes totally self-servicing. We want to do the same for the people who use Alto. That said, not everybody is proficient or comfortable with technology. In the spirit of accessibility and inclusivity, it will still be important that everyone who uses Alto also has the option to speak to a real, knowledgeable, and friendly person to get their questions answered and needs met. We have a responsibility as a healthcare provider to take care of all our patients, no matter how tech-savvy they might be, but for these patients we can still use technology to enable our team to get the patient the best possible option, quickly and easily.

Our engineering team is working toward products with even more expertise built in. In the process, we will also make our operations more efficient and more scalable, unblocking barriers to expansion in existing markets, new markets, and new verticals.

When we succeed at that alignment, we stand to change the nature of the industry. To get there, we will continue to grow our engineering team with right-fit, world-class talent that not only has the skillset to take Alto to the next level but also the values to keep us aligned and mission-driven in the process.

Learn more about Alto’s company values and mission-driven work culture.

At Alto, we’re putting patients first with free, same-day medication delivery; always-there, cost-saving support from our dedicated pharmacists and care team; and a cheerful online interface where people can conveniently manage all their prescriptions. Here’s how we make it work.

How Alto Pharmacy Is Using Tech to Put Patients First

Above all, Alto Pharmacy strives to fulfill medicine’s true purpose — to improve quality of life — for everyone who needs it. In working toward that mission, we’re building technology to disrupt the healthcare industry, which has long deprioritized the patient experience. At Alto, we’re putting patients first with free, same-day medication delivery; always-there, cost-saving support from our dedicated pharmacists and care team; and a cheerful online interface where people can conveniently manage all their prescriptions. Here’s how we make it work.

At the highest level, Alto is a pharmacy. But we are not a traditional pharmacy. Instead of operating dozens of small-volume distribution sites across a metro area like chain pharmacies, we own and operate high-volume pharmacy fulfillment centers staffed by small, highly efficient teams supported by proprietary technology. We have one fulfillment center per metro area that we serve, including San Francisco, Los Angeles, and Orange County, and a headquarters in Denver, where we are centralizing and growing our care operations team. Out of our fulfillment centers, we process and fill prescription orders and hand deliver them directly to patients’ homes or offices. About seven million people fall within the delivery zone of our San Francisco fulfillment center alone. In Southern California, our delivery radius covers another 20 million people.

Our model is made possible thanks to three Alto products:

With the easy-to-use Alto Patient app, people can consult a friendly and knowledgeable Alto pharmacist, schedule deliveries, and otherwise manage and learn more about their medications. Through the Alto Patient app, our care team also works with people to find them ways to save on their prescription costs.

Alto Connect is our physician-facing product that allows physicians to easily manage the pharmacy needs of their patients that use Alto. The beauty of Alto Connect is that it simplifies the workflows of the medical practices that use it. The typical clinic spends an average of 20 hours of administrative time per physician, per week, just on pharmacy workflows. In relieving practices of many of these administrative tasks, Alto reduces the likelihood of human error and redirects physicians’ time and energies back to their patients. In turn, Alto helps ensure treatment adherence and a better overall healthcare experience, making it a win-win for physicians and patients alike.

Wunderbar is the internal technology our pharmacists and care teams use to manage their workflows. It also controls the robots that fill every prescription order. Wunderbar was built and continues to be improved in house, giving us a strong foundation to grow and scale.

My co-founder, Matt Gamache-Asselin, and I came up with the idea for Alto in 2015, when we were working as software engineers at Parse, a Facebook-owned company. By then, our years in Silicon Valley had left us jaded and disillusioned with a tech industry that had lost sight of what really matters. We watched companies pour their resources into addressing the not-so-meaningful problems of the 1% while the broader population went underserved by many of the technological innovations being developed. We wanted to use our time, energy, and experience in consumer products to build something with the potential to have tangible, positive impact on the lives of all people. That led us first to healthcare — a big, broken industry with a terrible reputation — and then, more specifically, to pharmacy.

Our research revealed that no pharmacy incumbents think of themselves as consumer product companies. Unlike the Facebooks of the world, which are constantly optimizing how people use their products, pharmacy incumbents deprioritize it. We saw that gap as an opportunity to use our technical expertise to bring a people-focused mindset to the industry.

Back then, neither Matt nor I had any pharmacy experience. So, we left our jobs and dove in headfirst. After raising some capital, we purchased and ran a mom-and-pop operation, A-G Pharmacy, that had been serving San Francisco’s Mission District for more than 50 years.

We learned by fire how pharmacies work (and don’t). Soon enough, it became clear to us that despite caring about their patients, the A-G team wasn’t able to give them the best possible experience because they didn’t have the right tools. They were using antiquated software that required clumsy, inefficient work-arounds like relying on analog typewriters to create prescription labels. Because they didn’t have a streamlined operation, patients didn’t receive a streamlined experience.

We further discovered that technology wasn’t connecting the right stakeholders across the industry either. Pharmacy transactions require coordination between the physicians choosing the medication, the insurance companies paying for the medication, the pharmacies filling the orders, and the patients ultimately using the medications. The industry standard has been to conduct that coordination by fax and phone. That makes coordination slow, disjointed, and prone to things falling through the cracks. Patients take the brunt of those issues.

It became clear to us that Alto’s software needed to deeply integrate with and connect the disparate systems that stakeholders use. We also wanted to give stakeholders tools to solve other workflow issues not being addressed by their existing systems. And so Alto’s suite of products came to be.

A single Alto fulfillment center can serve as many people as 400 chain pharmacy locations, and we do it with a much smaller team thanks to our proprietary technology. That saves our company resources that we reinvest in the Alto experience. By way of example, we’ve developed specialized expertise in managing the coordination of complex therapeutics like fertility treatment, psychiatry, dermatology, and HIV prevention and care. The efficiencies we’ve uncovered make lifesaving and life-improving treatments available to people who might otherwise not have access to them.

The result is a system of products and processes that have demonstrated utility for tens of thousands of people and counting. Alto isn’t just convenient; by keeping people well informed about their prescription medications, Alto helps them make the best possible healthcare decisions for themselves and their families. But we’re not stopping there. Alto is poised for growth, and in the coming months and years, we will be rapidly adding to our team to help us build the technology to continue to solve pharmacy’s deep operational issues at scale.

Learn more about our vision, growth trajectory, and the Alto engineering team that makes it all possible.

Editor's Note: This post was updated on November 8, 2021, to reflect the rebrand of AltoMD to Alto Connect.

Women Leading the Way

On International Women’s Day, we’d like to celebrate the women of Alto. Every day, they care for patients, fill prescriptions, build products, and drive growth.

By the numbers, 63% of our employees, 40% of the executive team, and 60% of people leaders on product and engineering are women. In comparison, 20% of tech jobs are held by women and only 11 percent of executive positions at Silicon Valley companies.

This amazing representation was made possible by the company mission and values. The founders recognized that improving the pharmacy experience for a diverse population of patients meant Alto had to be a diverse company, capable of understanding and empathizing with everyone we serve.

Recruiting this talented mix of people has been one of our greatest successes, and today, our team has a broad representation of age, gender, race, sexual orientation, and socio-economic status. Diversity and inclusion is never a solved problem. We still and always will have room to improve, and will continue working hard to ensure D&I are prioritized as we continue to grow.

Focus at Alto: Providing the best care to Alto’s patients

Why did you join Alto? I was originally drawn to Alto for the opportunity to work at a pharmacy that was questioning the status quo and because, quite frankly, I could not possibly fathom how a pharmacy could have so many positive Yelp! reviews and I needed to see it with my own eyes. I quickly learned that the “Patients Come First” mentality was not just for show — it is brought to life every day through our incredible team and serves as the North Star for every strategic decision we make as a company.

Background: CVS Health, Walgreens, Northeastern

Focus at Alto: Keeping patient and provider information secure

Why did you join Alto? As a parent and patient, I am constantly frustrated by how hard it is to interact with doctors and data, in the name of security and privacy. I believe that we can secure patient data, protect their privacy and still make care accessible and convenient. I joined Alto Pharmacy because their passion for patients aligned so well with this belief. Alto feels like the kind of place I can be impactful. Also, the day I interviewed, they had a holiday cookie exchange and I’m a sucker for homemade baked goods.

Background: Mango Health, HP, Fortify Software, MIT

Focus at Alto: Building products that simplify medication management and improve health outcomes

Why did you join Alto? I love working on complex problems and creating user-friendly products to improve people’s lives. Everyone is a patient at some point in their lives, and we can make the experience so much better! The team here rallies around that mission, and approaches each decision with openness, rigorous intellectual honesty, and the desire to improve patients’ lives.

Background: Tesla, Boku, Intuit, QuestBridge, Stanford

FRANCES SCHENDLE, General Manager of Fertility

Focus at Alto: Developing and growing Alto’s Fertility Services

Why did you join Alto? In all my years in healthcare, I have never heard of a pharmacy creating an awesome experience for patients and clinicians! I wanted to be a part of this team’s mission to make healthcare simpler and more affordable for patients. The fertility space is a particularly meaningful area for me, as it is growing quickly but is still such a confusing and expensive journey. I believe Alto’s technology and dedicated fertility team are making this a more positive experience, and I’m excited to share that with more women and families.

Focus at Alto: Building products that transform pharmacy operations

Why did you join Alto? The two most important factors for me in a career move are 1) a clear, compelling company mission and 2) a strong yet humble team. When I met the Alto team, I was thrilled to find not only these attributes, but so much more to love. The founders set out to solve a hard problem, bought a brick and mortar pharmacy to learn the ropes, developed empathy with doctors, pharmacists and patients, and then built products that solved some of their thorniest problems. This approach demonstrates a hard-to-find mix of drive, fearlessness, humility and talent that I saw in droves as I met the rest of the Alto team. As someone who believes healthcare has to be so much better, I’m thrilled to spend my day contributing to that mission, with a team that inspires me… and shares lots of laughs every day!

Background: Granular, Inkling, BrightRoll, Apple, MIT, Berkeley

Empowering Patients By Accelerating Healthcare Innovation

Mattieu Gamache-Asselin, CEO & Co-founder

Editor's Note: This post was updated on November 8, 2021, to reflect the rebrand of AltoMD to Alto Connect.

Today, I’m proud to announce Alto’s Series C round of $50 million. Over the past three years, we’ve proven that Alto’s model works for doctors and patients alike, reducing administration time for physicians and improving drug adherence rates for patients. This new funding will enable us to expand, reaching even more patients, and to further develop our full-stack platform, driving better health outcomes at a lower cost.

Alto removes the complexity from prescriptions to improve patients’ quality of life. Every prescription requires coordination among doctors, insurance companies, pharmaceutical companies, and of course the patient. Traditional brick-and-mortar pharmacies depend on fax, phone and paper, which causes delays, errors in fulfillment, poor adherence rates, and 20 hours of administrative work a week per physician.

We’ve reimagined and completely rebuilt the pharmacy infrastructure to eradicate these problems. Through our provider platform (Alto Connect) and pharmacy management software, doctors and insurers spend less time on administration and more time on patient care. For patients, we offer free same-day prescription delivery, but more importantly, cost transparency, personalized in-app and phone support, and faster coordination with doctors and insurance companies to get patients the care they need. Learn more about our app.

The typical Silicon Valley playbook is to enter many new markets rapidly, throw money at problems, and figure things out on the fly. That’s never been Alto’s approach. Because we’re working with critical, life-saving medications, messing up is not an option. We’ve diligently, methodically built robust systems to make certain we leave no patient behind, and we’ll keep that mentality as we expand. Now that we’ve built our critical foundations — the platforms and clinical expertise — it’s time to scale.

Geographic expansion
We want to make sure all of America can benefit from the Alto experience. Last month, we opened our HQ2 in Denver, where we’ve already hired 60 employees across patient care, pharmacy and clinical operations, as a stepping stone to nationwide expansion.

Therapeutic area expansion
So far, we’ve focused on deeply understanding and serving the retail, dermatology, fertility, biologics, and HIV markets. We’re now bringing the same empathy and customized service to autoimmune, endocrinology, and cardiology — areas where patients are frequently overwhelmed with logistics, paperwork and side effects, and where Alto could offer deep value as a trusted partner.

Pharmacy represents 10% of healthcare spending, a $3.3 trillion market. Most pharmacies focus on just capturing as much of that 10% as possible. A select few are working to eliminate the ineffective portions of pharmacy spending. But even they look at the pharmacy spending in isolation.

The truth is, pharmacy shouldn’t be viewed as a disjoint piece. At Alto, we believe better pharmacy will make all of healthcare more effective and reduce healthcare spending overall. We’ve already seen progress — for instance, Alto’s primary adherence rate is 40% higher than the industry average.

From patients, we’ve heard, “Being able to speak to an Alto pharmacist directly allowed me to figure out how my drugs were interacting and causing painful side effects.” Some patients are cost-sensitive and consider skipping the medications that manage their chronic conditions and prevent hospitalizations. We’ve helped by delivering $11 million in medication savings to our patients so far.

From doctors, a common refrain is: “This is the first time my patients have talked to me positively about a pharmacy, and it’s the first time I can actually see what happens to a prescription after I write it.” This experience is why doctors have been the primary fuel of Alto’s growth. UCSF, One Medical, Stanford, and over 10,000 other providers recommend Alto as their preferred pharmacy.

This early progress is energizing, and only possible because of the dedication of Alto’s hardworking team, investors, and partners. Thank you all! The feedback I’m getting from the health ecosystem is even more inspiring — that our potential is nothing short of transformative for our patients and healthcare as a whole. As far as we’ve come, we’re only just getting started.

Blog

Help Us Shape the Future of Healthcare

Are You Right for Alto?

How Alto Pharmacy Is Using Tech to Put Patients First

Women Leading the Way

Empowering Patients By Accelerating Healthcare Innovation

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