As a Software Engineer at Tempus Labs, you will sit at the intersection of technology and precision medicine. You will design, build, and scale the critical software infrastructure that processes immense volumes of clinical and genomic data. Your work directly empowers physicians to make real-time, data-driven treatment decisions, accelerating the pace of personalized cancer care and therapeutic discovery. The engineering team is responsible for developing high-performance data pipelines, robust APIs, and interactive visualization tools that make complex biological data accessible and actionable. This role requires solving complex distributed systems challenges, optimizing data storage, and ensuring the seamless integration of machine learning models into clinical workflows. Every line of code you write contributes to a platform that handles highly sensitive healthcare data at an unprecedented scale. Working here means tackling unique software challenges where reliability and accuracy are paramount. You will collaborate closely with cross-functional teams of data scientists, product managers, and clinical researchers to build solutions that directly impact patient outcomes. It is a fast-paced, mission-driven environment where technical rigor meets life-saving application.
Recruiter Screen
reportedInitial rapid screen to align on your background and interest in the company.
What to demonstrate
- Initial rapid screen to align on your background and interest in the company
- Depth in System Design
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.
Technical Screen
reportedAssessment of foundational programming and database knowledge through online assessment.
What to demonstrate
- Assessment of foundational programming and database knowledge through online assessment
- Depth in System Design
How to prepare
- Answer aloud and timed: Solve a classic array manipulation problem (such as finding duplicates or subarray sums) within an optimal time complexity.
- Answer aloud and timed: Write a program to parse, clean, and format unstructured clinical trial text inputs.
Virtual Onsite Interview
reportedComprehensive interview loop with multiple rounds focusing on live coding, system design, and behavioral alignment.
What to demonstrate
- Comprehensive interview loop with multiple rounds focusing on live coding, system design, and behavioral alignment
- Depth in System Design
How to prepare
- Answer aloud and timed: Design a RESTful API using Node.js and Express to handle real-time clinical data ingestion.
- Answer aloud and timed: How would you design a scalable clinical trial matching system that handles millions of patient profiles and complex eligibility criteria?
PracHub editorial advice for the preparation topics above.
Master the JavaScript Ecosystem
Given our heavy reliance on Node.js, Express, and React, brush up on core language concepts such as promises, async/await, closures, and state management before your technical rounds.
Practice SQL Aggregations
Ensure you can comfortably write and optimize queries on the fly. Focus on relational database design principles and understand when to normalize versus denormalize data.
Be Ready for Behavioral Scenarios
Prepare concrete examples of how you have handled shifting priorities, resolved technical disagreements, and collaborated with product managers in past roles.
Ask Clarifying Questions
During both the coding and system design rounds, avoid jumping straight into a solution. Take a few minutes to clarify requirements, discuss edge cases, and outline your approach with your interviewers.
Choose a category, try a prompt, then open its approach, worked solution or follow-up when you need it.
Given an input string, write a function to calculate the term frequency-inverse document frequency (TF-IDF) of
Given an input string, write a function to calculate the term frequency-inverse document frequency (TF-IDF) of specific terms.
Approach
- Restate the input: its shape, its size, and what is guaranteed about it.
- Name the brute-force solution and its complexity before improving on it.
- Choose the data structure from the access pattern, not from familiarity.
- 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?
Implement a function that processes an array of data and outputs a specific string format based on dynamic inp
Implement a function that processes an array of data and outputs a specific string format based on dynamic input parameters in JavaScript.
Approach
- Restate the input: its shape, its size, and what is guaranteed about it.
- Name the brute-force solution and its complexity before improving on it.
- Choose the data structure from the access pattern, not from familiarity.
- 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?
Solve a classic array manipulation problem (such as finding duplicates or subarray sums) within an optimal tim
Solve a classic array manipulation problem (such as finding duplicates or subarray sums) within an optimal time complexity.
Approach
- Restate the input: its shape, its size, and what is guaranteed about it.
- Name the brute-force solution and its complexity before improving on it.
- Choose the data structure from the access pattern, not from familiarity.
- 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?
Write a program to parse, clean, and format unstructured clinical trial text inputs.
Write a program to parse, clean, and format unstructured clinical trial text inputs.
Approach
- Restate the input: its shape, its size, and what is guaranteed about it.
- Name the brute-force solution and its complexity before improving on it.
- Choose the data structure from the access pattern, not from familiarity.
- 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?
Write a SQL query to join patient demographic tables with clinical test results, returning the most recent tes
Write a SQL query to join patient demographic tables with clinical test results, returning the most recent test record per patient.
Approach
- Name the grain you start from and join outward from it.
- Check whether any join is one-to-many before aggregating, or the sums inflate.
- Say which index the query would use, and what makes it unusable.
- 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?
How would you optimize a slow-performing SQL query that aggregates large volumes of daily diagnostic data?
How would you optimize a slow-performing SQL query that aggregates large volumes of daily diagnostic data?
Approach
- Name the grain you start from and join outward from it.
- Check whether any join is one-to-many before aggregating, or the sums inflate.
- Say which index the query would use, and what makes it unusable.
- 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?
Design a RESTful API using Node.js and Express to handle real-time clinical data ingestion.
Design a RESTful API using Node.js and Express to handle real-time clinical data ingestion.
Approach
- Fix the scope first: who calls this, how often, and what they do when it fails.
- Name the read and write paths separately; they rarely have the same bottleneck.
- Choose a partition key and say what query it makes expensive.
- State the consistency you need, and where you are willing to be stale.
Follow-up
- What breaks first when traffic grows ten times?
- How does this behave when that dependency is down for an hour?
How would you design a scalable clinical trial matching system that handles millions of patient profiles and c
How would you design a scalable clinical trial matching system that handles millions of patient profiles and complex eligibility criteria?
Approach
- Fix the scope first: who calls this, how often, and what they do when it fails.
- Name the read and write paths separately; they rarely have the same bottleneck.
- Choose a partition key and say what query it makes expensive.
- State the consistency you need, and where you are willing to be stale.
Follow-up
- What breaks first when traffic grows ten times?
- How does this behave when that dependency is down for an hour?
Discuss the architectural trade-offs of using a relational database versus a NoSQL database for storing genomi
Discuss the architectural trade-offs of using a relational database versus a NoSQL database for storing genomic sequencing results.
Approach
- Fix the scope first: who calls this, how often, and what they do when it fails.
- Name the read and write paths separately; they rarely have the same bottleneck.
- Choose a partition key and say what query it makes expensive.
- State the consistency you need, and where you are willing to be stale.
Follow-up
- What breaks first when traffic grows ten times?
- How does this behave when that dependency is down for an hour?
Explain how you would implement rate limiting and secure authentication for a public-facing healthcare API.
Explain how you would implement rate limiting and secure authentication for a public-facing healthcare API.
Approach
- Say who the caller is and what they do when the call fails halfway.
- Define the identity of a request so a retry cannot double-apply it.
- Separate accepted, pending, failed and confirmed; they are different facts.
- Design the error taxonomy before the success shape; callers branch on it.
Follow-up
- What happens if the caller retries after a timeout?
- How does a client discover it is on an old version of this contract?
Explain the difference between inner joins, outer joins, and subqueries, and when to use each when querying cl
Explain the difference between inner joins, outer joins, and subqueries, and when to use each when querying clinical datasets.
Approach
- Clarify what is being asked and what a complete answer contains.
- State your assumptions explicitly before working the problem.
- Say what you would check first and why it is the highest-information step.
- Work from the requirement backwards to the design.
Follow-up
- What assumption would you test first?
- How would you know your answer was wrong?
Read latency spikes on a sixty-second sawtooth
The cached listing read path serves about 14k reads/second at an 85% hit rate. p99 sits at 35 ms for 57 seconds, jumps to 900 ms for 3, and repeats. During each spike the primary shows several hundred identical listing queries starting within the same millisecond, all carrying one large tenant's id. Cache entries use a 60-second TTL. Give the mechanism, the ordered checks, the fix, and the correctness hazard your fix must not introduce.
Approach
- Match the period to a configured number before theorising about load. A spike every 60 seconds against a 60-second TTL is an entry expiring, and you confirm it by correlating spike timestamps with the entry's write time rather than with the traffic curve. If the period had matched a cron or a GC interval instead, this is a different investigation.
- Establish the concurrency of the miss. Several hundred identical queries in one millisecond means the miss path has no coalescing: every request that arrives between expiry and repopulation recomputes. The herd size is that key's arrival rate times its recompute time, so at 1.2k reads/second for the hot key and a 250 ms recompute you expect about 300 concurrent misses, which matches what is observed.
- Add single-flight on the miss path so one caller per key recomputes under a short-lived lock while the rest wait for its result. Prefer stale-while-revalidate where the read tolerates it: return the expired value immediately and refresh asynchronously, which removes the latency spike rather than serialising it into a queue of waiters.
- De-synchronise the keys. Write TTLs with jitter, for example 60 seconds plus or minus 10%, so a deploy or a mass invalidation does not align every key on the same second and turn a per-key herd into a fleet-wide one.
Follow-up
- The same sawtooth appears on a key that is invalidated on write rather than expired. Is that the same bug?
- How does your answer change if the recompute takes 4 seconds instead of 250 ms?
Built from the rounds and topics Tempus labs candidates report.
Prepare, practise & reflect
One practical outcome each day. Spend longer where you need it.
0 / 7 done01Map the Tempus labs loop
- Write out the reported sequence: Recruiter Screen, Technical Screen, Virtual Onsite Interview.
- 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 3 reported rounds, with the weakest marked.
02Work System Design
- Spend the session on System Design, which Tempus labs candidates report being tested on.
- Write one worked example in System Design and time yourself on it.
Deliverable: One timed worked example in System Design.
03Work Coding Interview Practice
- Spend the session on Coding Interview Practice, which Tempus labs candidates report being tested on.
- Write one worked example in Coding Interview Practice and time yourself on it.
Deliverable: One timed worked example in Coding Interview Practice.
04Work JavaScript
- Spend the session on JavaScript, which Tempus labs candidates report being tested on.
- Write one worked example in JavaScript and time yourself on it.
Deliverable: One timed worked example in JavaScript.
05Answer out loud: Coding and Algorithms
- Answer aloud, timed: Given an input string, write a function to calculate the term frequency-inverse document frequency (TF-IDF) of specific terms.
- Answer aloud, timed: Implement a function that processes an array of data and outputs a specific string format based on dynamic input parameters in JavaScript.
Deliverable: Spoken answers to 2 reported Coding and Algorithms question(s), under time.
06Answer out loud: System Design and API Development
- Answer aloud, timed: Design a RESTful API using Node.js and Express to handle real-time clinical data ingestion.
- Answer aloud, timed: How would you design a scalable clinical trial matching system that handles millions of patient profiles and complex eligibility criteria?
Deliverable: Spoken answers to 2 reported System Design and API Development question(s), under time.
07Answer out loud: Database and SQL
- Answer aloud, timed: Write a SQL query to join patient demographic tables with clinical test results, returning the most recent test record per patient.
- Answer aloud, timed: How would you optimize a slow-performing SQL query that aggregates large volumes of daily diagnostic data?
Deliverable: Spoken answers to 2 reported Database and SQL question(s), under time.
Expand any day for tasks and deliverables. Your progress is saved on this device.
Behavioural rounds judge the decision you made and what it cost.
Describe a time when you had to work under tight deadlines with constantly shifting product priorities. How di
Describe a time when you had to work under tight deadlines with constantly shifting product priorities. How did you manage your time and deliver?
Approach
- Pick a story where you made the decision, not one where you watched it.
- State the situation in two sentences and spend the rest on the reasoning.
- Give the blast radius: what could have broken, and what you measured.
- 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 handle a situation where there is a disagreement between engineering and product management regardi
How do you handle a situation where there is a disagreement between engineering and product management regarding a feature's technical scope?
Approach
- Pick a story where you made the decision, not one where you watched it.
- State the situation in two sentences and spend the rest on the reasoning.
- Give the blast radius: what could have broken, and what you measured.
- 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?
Why are you interested in joining Tempus Labs, and how do you see your engineering background contributing to
Why are you interested in joining Tempus Labs, and how do you see your engineering background contributing to our mission of precision medicine?
Approach
- Pick a story where you made the decision, not one where you watched it.
- State the situation in two sentences and spend the rest on the reasoning.
- Give the blast radius: what could have broken, and what you measured.
- 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?
Tell me about a complex technical challenge you solved in your previous role. How did you communicate the tech
Tell me about a complex technical challenge you solved in your previous role. How did you communicate the technical details to non-technical stakeholders?
Approach
- Pick a story where you made the decision, not one where you watched it.
- State the situation in two sentences and spend the rest on the reasoning.
- Give the blast radius: what could have broken, and what you measured.
- 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?
- 01
Describe a time when you had to work under tight deadlines with constantly shifting product priorities. How did you manage your time and deliver?
- 02
How do you handle a situation where there is a disagreement between engineering and product management regarding a feature's technical scope?
- 03
Why are you interested in joining Tempus Labs, and how do you see your engineering background contributing to our mission of precision medicine?
- 04
Tell me about a complex technical challenge you solved in your previous role. How did you communicate the technical details to non-technical stakeholders?
What is the typical timeline for the hiring process?
The entire process generally takes between three to five weeks from the initial recruiter screen to the final decision. The speed often depends on candidate availability and the scheduling of the multi-session virtual onsite.
Tempus labs Software Engineer candidate reports ↗Can I use any programming language during the technical rounds?
While recruiters may mention that you can choose your preferred language, our engineering stack is heavily focused on JavaScript and Node.js. Candidates who complete the live coding sessions in JavaScript often find it easier to demonstrate the specific framework knowledge our teams look for.
Tempus labs Software Engineer candidate reports ↗How heavily is SQL evaluated in the interview process?
SQL is a core requirement and is tested during both the online assessment and the onsite rounds. You should be highly comfortable writing queries that involve complex joins, aggregations, and subqueries.
Tempus labs Software Engineer candidate reports ↗What is the structure of the system design round?
The system design round is a one-hour conversational interview with two engineers. You will be asked to design a high-level architecture for a realistic healthcare application, focusing on scalability, database selection, API design, and data flow.
Tempus labs Software Engineer candidate reports ↗What is the working style and engineering culture like?
The engineering culture is fast-paced, collaborative, and highly mission-driven. Teams work in agile sprints and prioritize shipping features quickly to keep pace with shifting clinical and product priorities, requiring engineers to be adaptable and proactive.
Tempus labs Software Engineer candidate reports ↗What is the interview process for Tempus Labs Software Engineer, and how many rounds are there?
The Tempus Labs Software Engineer process starts with a Recruiter Screen, then a Technical Screen using an online assessment. If you pass, you move to a Virtual Onsite Interview, described as a comprehensive loop with multiple rounds focused on live coding, system design, and behavioral alignment.
Tempus labs Software Engineer candidate reports ↗How hard is the Tempus Labs Software Engineer interview compared to other companies?
That suggests you should prepare for both accurate coding execution and stronger-than-baseline system design and API reasoning, since the onsite loop covers live coding, system design, and behavioral topics. Plan your prep to be solid end to end rather than relying on one area.
Tempus labs Software Engineer candidate reports ↗What technical topics does Tempus Labs test for Software Engineers?
Tempus Labs Software Engineer interviews commonly emphasize System Design and Coding Interview Practice, alongside Data Structures & Algorithms. You should also expect coverage of JavaScript and Node.js, REST API implementation, and SQL. The preparation guidance also stresses clean, correct code with edge case handling during automated coding challenges.
Tempus labs Software Engineer candidate reports ↗What does the Tempus Labs Software Engineer technical screen assess?
The Technical Screen is described as an online assessment that evaluates foundational programming and database knowledge. Because the broader onsite includes live coding and system design, treat this screen as verifying that your core coding and SQL fundamentals are ready before you reach deeper architecture questions.
Tempus labs Software Engineer candidate reports ↗What kind of system design and API questions do Tempus Labs Software Engineers get?
System design and API questions at Tempus Labs focus on scalable, reliable backend services and clean interfaces. Example topics include designing a RESTful API using Node.js and Express for real time clinical data ingestion, plus discussing architectural trade offs like relational versus NoSQL for genomic sequencing results. You may also be asked about implementing rate limiting and secure authentication for a public facing healthcare API.
Tempus labs Software Engineer candidate reports ↗How much do Tempus Labs Software Engineers make, and what affects pay?
Your reported data here does not include offer rates for this role, and it does not provide specific compensation figures. If your goal is to estimate pay, you will need additional compensation detail beyond what is shown, since pay can vary by level and location in general but no exact ranges are provided in the supplied materials.
Tempus labs Software Engineer candidate reports ↗Sources & methodology 3 sources ↗
No official company page is cited. Rounds and questions come from candidate reports and PracHub editorial material; each source shows the date it was read.
- 01Tempus labs Software Engineer candidate reports ↗
Company-reported rounds, questions and FAQ.
Candidate reports · Accessed 2026-09-22 - 02PracHub Software Engineer practice ↗
PracHub practice material, not company-reported.
PracHub page · Accessed 2026-09-22 - 03PracHub preparation framework ↗
PracHub preparation guidance.
PracHub page · Accessed 2026-09-22
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