Your Fractional Development + Design Partner

For $6,000/mo, I become a trusted member of your team, delivering code, design, and strategic output every single day. No hours cap, flexible scopes, and zero surprises.

I partner with healthcare startups that need a senior engineer who also “gets” design and is easy to work with. Instead of juggling multiple freelancers or waiting on quotes, you get a single point of contact who’s with you on Slack, in standups, and shipping features every week—without the usual friction of hourly billing.

What you get

• Solve complex front-end, back-end, and UX challenges
• Implement HIPAA-compliant, secure web applications & infrastructures
• Get strategic insights from a senior engineer who cares about your bottom line
• Enjoy steady momentum: no re-onboarding or negotiating scopes
• A fully insured contractor with good security best practices for your General Counsel's peace of mind

How I Work

Most freelance developers will bid on a project, deliver the scope, and move on. That leaves you with the burden of ramping up a new dev the next time something changes, or worse, a half-finished product if the scope wasn’t perfectly defined up front.

I work differently. Through a staff augmentation retainer, I become your part-time or fractional team member. I’m there for standups, Slack discussions, strategic planning sessions—whatever your existing rituals are. You get ongoing continuity, broader expertise, and faster delivery because I’m already on board, up to date on the codebase, and fully aligned with your business objectives. You don’t have to keep “starting over” every time you need something new.

For one flat monthly fee:

• I join your team’s daily rituals (standups, Slack, planning sessions)
• You hand me priorities, and I ship code and design deliverables
• No hour-tracking or “scope creep” nightmares—just continuous progress

I only take on two clients at once, so you get my undivided attention whenever you need me.

Need to pivot or add new features? We adapt on the fly. My priority is to keep your product moving forward.

Who This Is For

• Early-stage Healthcare Startups: Need a fractional lead engineer to shape your tech vision and actually build it out? I can do both, so you can focus on customers, fundraising, and growth.
• Small-To-Mid-Size Healthcare Companies: If you have a product team but need an experienced engineer/designer who can ship features quickly and handle all those tricky technical decisions, let’s talk.
• Established Healthcare Businesses & Innovation Teams: Want to prototype a new feature or spin up a new product line without pulling your current devs off the main roadmap? I’ll embed as a staff augmentation resource and move fast while maintaining best practices.

Guiding Principles

• Partners, Not Clients. Your success is my success, so I care about your product’s performance as if it were my own startup. My goal is to align my work with your business impact, not just project deliverables.
• Focus On The Next Most Useful Thing. Momentum is gold. I’m always thinking about how to remove blockers and push your product forward. Whether I’m implementing a new feature, refining your UI, or brainstorming product strategy, it’s about continuous, meaningful progress.
• Forward-Thinking & Grounded. My approach is positive yet realistic—finding solutions that move us forward while staying mindful of technical constraints. I welcome bold ideas, and we’ll refine them together until we find the best way to achieve your goals.
• Strategy & Hands-On Work. I love being involved in both the “big-picture” and day-to-day execution. Each informs the other—strategy without action is just theory, and action without strategy wastes resources.
• Numbers & Empathy. Data can guide us, but truly understanding your users requires a personal touch. From user interviews to qualitative feedback, I ensure we’re making decisions that resonate with real people—not just spreadsheets.

Capabilities

• Front-End: React, Next.js, Tailwind, design systems, pixel-perfect UI
• Back-End: Node.js, Express, serverless, GraphQL/REST APIs, secure DB integration, HIPAA compliance
• Design & Prototyping: Figma, user research, iterative UX validation
• Product Strategy: MVP planning, user feedback loops, data-driven iteration

How We’ll Work Together

• Kickoff & Alignment: We’ll discuss your goals, existing process, and top priorities. I'll happily sign a BAA before starting work. Then I jump right in.
• Embedded in Your Team: I participate in your standups and planning. You can assign me tasks anytime — we’ll communicate via Slack or your project management tool.
• Continuous Delivery: I don’t waste time with quotes for every feature. I push production-ready code/design weekly, with demos or check-ins whenever you need them.
• Adapt & Scale: Whether your product needs a quick pivot or a new integration, I’m flexible. You have a fractional engineer & designer at your fingertips, stress-free.

Who I Work With

Since 2012, I’ve collaborated with a wide range of clients worldwide—from small design agencies to multi-million-dollar companies such as LinkedIn and KonMari Media. My projects have been featured in TechCrunch, NBC News, The Wall Street Journal, NPR, and Time Inc., among others.

Monarch

I built and launched a medical membership platform that generated hundreds of thousands of dollars within its first weeks. I was able to get an MVP delivered in just seven days and recently helped launch a re-branding effort as well as a back-end migration to a more robust system. This is an ongoing project that I'm really proud of and look forward to continuing in the future.

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Graphite Health

Led the front-end development for Graphite's website redesign, creating a high-performance and visually compelling platform. The site was designed to serve dual purposes: attracting investors and collaborators while also appealing to top talent. I implemented Sanity as the Content Management System and integrated various third-party tools through custom-built solutions, ensuring seamless functionality and a smooth user experience.

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Looking Glass Factory

For over six years I helped Looking Glass Factory build and maintain multiple versions of their website and online store, going from a legacy WordPress site to a modern, fully-featured e-commerce platform powered by Shopify and a Headless CMS. I worked closely with the team to ensure the site was optimized for conversions and provided a seamless user experience across all channels. We also worked on other customer-facing projects, such as an innovative application for turning 2D photos into 3D/holographic portraits.

I’ve worked with Mariano for 6 years and he has always come through with incredible skill for us with our most challenging projects. He was instrumental in several major updates to our website. If you get a chance to work with Mariano, take it!

Let’s Work Together!

I charge a flat-rate fee of $4,500 per month. I'll ask for 50% of your first month upfront before we start work.

I intentionally limit myself to just two ongoing retainer clients because great work requires focus. If you’re reading this, there’s a chance I still have an opening. If you want to explore how we can make your product vision a reality, let’s start a conversation.

Drop me a line at office@marianomiguel.com to book an intro call.