Vantaggi
The culture is exactly what I want from a software development position. The company is nearly completely run by developers. There just isn't a sense of marketing or greed or politics in the day-to-day work. All the way up the chain everybody knows how things really work and there isn't a habit of over-promising or hyping things that aren't realistic. The tech stack has quickly shifted to more relevant platforms than in the past, and the willingness to try out new things has rapidly increased. The work itself is among the most meaningful that anybody in development could hope to work on. Processes, rules, and things like that just make sense, and if they don't then the culture is one of extreme openness to feedback to get to whatever is right. Truly a we're-all-on-the-same-team mentality that really works.
Svantaggi
Going all-in on development leadership means that developers really are responsible for things they may not be expecting. Communication and self-managing skills are really important. Healthcare is extraordinarily complicated and fragmented at times, so building software to capture all that complexity alongside stalwarts of the industry is a daunting task. Processes go hand-in-hand with dealing with it all, so there's a bunch of them.