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Agent guide: [/agents.md](https://www.wearedevelopers.com/agents.md). --- # Senior Backend Engineer (Community) - **Company:** Papa Inc - **Location:** San Francisco, CA, United States - **Experience:** Expert - **Salary:** $160,000.0 - $210,000.0 - **Contract:** Permanent contract - **Skills:** Application Programming Interfaces (APIs), ASC X12 Standards, Code Review, Data Governance, Data Infrastructure, DevOps, Distributed Systems, Python (Programming Language), Ruby on Rails, Software Engineering, Fast Healthcare Interoperability Resources, Delivery Pipeline, Reliability of Systems, Backend, Health Level Seven International, Api Design, Data Pipelines, Elixir - **Published:** August 6, 2026 - **Apply:** https://www.indeed.com/viewjob?jk=6e7c73167c322dae ## About the Role A genuine appetite for ambiguity and ownership - You're energized by open questions and evolving standards. You don't wait to be handed a fully-scoped task - you enjoy taking ownership of the problem itself and figuring out the right way to solve it. A bias toward velocity - You want to ship, see it working, and iterate. You feel the urgency of building something that patients and clinicians depend on. Product mindset - You think like a founder, balancing technical excellence with business outcomes, revenue, and patient impact. You see gaps as opportunities and help define what we build, not just how. Independent ownership - You independently own the full lifecycle of features and projects - design, development, deployment, and monitoring - without needing a fully-scoped spec handed to you. Strong backend expertise - Solid understanding of distributed systems, API design, and scalable architecture. We build in Elixir, and look for candidates with solid understanding of Elixir even if they are not using it in their current professional setting. System design and reliability - You build resilient, well-tested systems with proper monitoring, rollout practices, and production stability for healthcare-critical workloads. High autonomy and ownership - You thrive in ambiguous environments, educate non-technical stakeholders, and own outcomes without needing detailed requirements or constant direction. Startup adaptability - You're highly communicative across operational and clinical teams, move fast when needed, and understand when to ship quickly versus architect for scale. Continuous improvement mindset - You proactively identify areas for improvement in systems and processes without being asked, and drive initiatives to address them., * 6+ years of software development experience * Strong proficiency in Ruby on Rails or Python * 1+ years of hands-on experience with Elixir * Experience building and shipping high quality work and achieving high reliability * Experience improving quality through thoughtful code reviews, appropriate testing, proper rollout, and monitoring * Passionate about improving healthcare access and outcomes, * Experience working as one of the first engineers at an early-stage startup, or otherwise building without an established engineering org around you * Deeper Elixir expertise, including Phoenix LiveView * Experience with healthcare technology including data standards (FHIR, HL7, X12), EHR/vendor integrations, HIPAA-compliant systems for protected health information, and healthcare-specific APIs (clearinghouses, billing platforms) ## Description We are growing our founding engineering team and looking for a Senior Backend Software Engineer to join Papa Community. You'll work alongside our Staff Backend Engineers and report directly to Papa Community's GM, with dotted-line mentorship from Papa core's engineering leadership. This is a rare chance to help shape a platform in its earliest days without giving up the stability of an established company behind you. As Papa Community's engineering team grows, there will be more opportunities to take on broader technical leadership - this role is a chance to build that track record early, working alongside our Staff Engineers and partnering directly with the GM. This role is unique because: You'll help extend the technical architecture for Papa Community. Working alongside our Staff Backend Engineers, you'll contribute to system design, technology choices, and engineering practices that will define Community for years to come. You'll own problems, not tickets. You won't be handed a fully-scoped spec and asked to implement it - you'll be handed a problem the business is facing and given real latitude to figure out the best way to solve it. If what excites you is being trusted to figure out what to build and why, this is the role for you. You'll partner directly with the GM. Your voice will shape product decisions, build vs. buy trade-offs, and day-to-day technical priorities. You'll leverage Papa's infrastructure while maintaining startup velocity. You can access Papa's deployment pipelines, security compliance, and DevOps support - but make decisions in days, not weeks, and ship at a pace that matches the urgency of the people we serve. You'll get institutional advantages without enterprise bureaucracy. What makes this role challenging: You'll navigate complex healthcare integrations. Our platform connects EHRs, care management platforms, revenue cycle management, and patient communication tools. You'll need to build strong familiarity with healthcare data standards (FHIR, HL7, X12) and resilient API integration patterns. You'll balance technical perfection with shipping velocity. We're a startup - sometimes the right answer is "ship it and iterate" rather than "architect the perfect solution." You'll need judgment to know when to build for scale and when to move fast, and a genuine bias for action. You'll work in a high-autonomy environment with a lot of open questions and comparatively little established process. You'll influence stakeholders, make recommendations, and own outcomes. What you'll do: Build out our platform. You'll help build and scale Papa Community's proprietary platform - the operational backbone for our care team. This is a multi-quarter build with substantial room to grow. Strengthen our revenue cycle management pipeline. You'll work on ongoing integration and improvement of our RCM vendor relationship - claims data pipelines, denial handling, and patient responsibility workflows that need continued investment as billing volume grows. Extend our platform and tooling investments. You'll help build out remaining platform needs, including transactional email, customer support tooling, and other member- and internal-facing systems. Enable operational intelligence and automation. You'll help build the data infrastructure and tooling that allows our clinical team to make informed decisions, automate care workflows, and track patient outcomes in real-time. This includes everything from patient dashboards to automated patient outreach triggers to clinical decision support. Contribute to critical technical decisions. You'll weigh in on build vs. buy trade-offs and technology choices, partnering with our Staff Engineers and the GM on our technical roadmap. Support engineering practices as we grow. You'll help maintain code standards, testing expectations, deployment processes, and technical documentation practices as we grow the team. Own system reliability and performance for the areas you build. This means building resilient systems for healthcare-critical workflows where reliability isn't optional - claim submissions, patient data accuracy, and care coordination all need to work consistently. ## Related Videos - [Meet Your New BFF: Backend to Frontend without the Duct Tape](https://www.wearedevelopers.com/videos/682-meet-your-new-bff-backend-to-frontend-without-the-duct-tape) - [Developing the Backend with Stefan Lingler, CTO at Shpock](https://www.wearedevelopers.com/videos/100360-developing-the-backend-with-stefan-lingler-cto-at-shpock) - [Bringing digital education to refugee and host communities in remote regions of Africa](https://www.wearedevelopers.com/videos/644-bringing-digital-education-to-refugee-and-host-communities-in-remote-regions-of-africa) - [From DevOps to Scaled DevOps: How We’re Rebuilding Continuous Delivery as a Platform](https://www.wearedevelopers.com/videos/100018-from-devops-to-scaled-devops-how-we-re-rebuilding-continuous-delivery-as-a-platform) - [Inside Bitpanda's Tech Stack: Scaling a European Fintech Leader - Markus Dorner](https://www.wearedevelopers.com/videos/1979-inside-bitpanda-s-tech-stack-scaling-a-european-fintech-leader-markus-dorner) - [Nest.js - TypeScript in the backend can also be clean](https://www.wearedevelopers.com/videos/1033-nest-js-typescript-in-the-backend-can-also-be-clean) ## Related Articles - [The 7 Most Popular Backend Frameworks for Developers](https://www.wearedevelopers.com/magazine/403-the-7-most-popular-backend-frameworks-for-developers) - [What’s the Difference Between Frontend and Backend Development?](https://www.wearedevelopers.com/magazine/240-what-s-the-difference-between-frontend-and-backend-development) - [Fully Remote Software Engineer Jobs](https://www.wearedevelopers.com/magazine/447-fully-remote-software-engineer-jobs) - [How We Built a Worry-Free System That Runs for 10+ Years – And What We’d Do Again](https://www.wearedevelopers.com/magazine/751-how-we-built-a-worry-free-system-that-runs-for-10-years-and-what-we-d-do-again) - [Find a Developer Job: 12 Best Job Sites For Developers](https://www.wearedevelopers.com/magazine/165-find-a-developer-job-12-best-job-sites-for-developers) - [The Biggest German Tech Companies](https://www.wearedevelopers.com/magazine/424-the-biggest-german-tech-companies)