Backend Engineer

technical direction for a large-scale healthcare platform supporting primary care programs across Africa; - Lead modernization, refactoring, and redesign initiatives across existing backend systems and services; - Design scalable, secure, and maintainable solutions using C#, .NET, Azure, SQL Server/PostgreSQL, and distributed architectures; - Drive healthcare interoperability initiatives, including HL7/FHIR integrations and connections with national health systems, laboratories, and third-party platforms; - Guide engineering teams on architecture, coding standards, performance optimization, and technical best practices; - Mentor engineers through code reviews, design reviews, and day-to-day technical leadership; - Collaborate closely with the CTO, product, clinical, data, and DevOps teams on roadmap execution and technology decisions; - Support development of offline-first healthcare workflows and synchronization solutions for low-connectivity environments; - Improve platform

reliability, scalability, security, and operational efficiency as the business expands across multiple countries; - Participate in incident resolution and technical problem-solving for mission-critical healthcare systems requiring rapid response times; - Evaluate and introduce new technologies, architectural patterns, and AI/data-driven capabilities where appropriate; - Contribute hands-on to solution design and complex implementation work when needed; - This role may require occasional travel to Africa based on business and project requirements. MUST HAVES - 8+ years software engineering experience; - 3+ years Technical Lead / Architect experience; - C#; - .NET Framework; - .NET Core / .NET 6+; - SQL Server and/or PostgreSQL; - REST APIs; - Distributed systems; - Azure; - EMR / EHR experience; - HL7 and/or FHIR; - Healthcare interoperability; - Architecture ownership; - Mentoring engineers; - Code reviews; - Technical roadmap participation; - Strong stakeholder communication; - Upper-intermediate English level. NICE TO HAVES - OpenMRS; - National healthcare integrations; - Offline-first systems; - Docker/Kubernetes; - Data platforms / analytics; - AI in healthcare; - Public health systems; - Africa healthcare programs; - Knowledge

AgileEngine is an Inc. 5000 company that creates award-winning software for Fortune 500 brands and trailblazing startups across 17+ industries. We rank among the leaders in areas like application development and AI/ML, and our people-first culture has earned us multiple Best Place to Work awards. WHY JOIN US If you’re looking for a place to grow, make an impact, and work with people who care, we’d love to meet you ABOUT THE ROLE We are looking for a Senior Backend Engineer to own the technical direction and architecture of a large-scale healthcare platform supporting primary care programs across Africa. You will lead modernization and redesign initiatives using C#, .NET Core, Azure, and SQL Server/PostgreSQL, drive HL7/FHIR interoperability with EMR and national health systems, and mentor engineers through architecture and code reviews. The role includes hands-on contribution to complex implementation work and occasional travel to Africa. WHAT YOU WILL DO - Own architecture and