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# Backend Engineer, Infrastructure

- **Company:** Ellipsis Health, Inc.
- **Location:** San Francisco, CA, United States
- **Experience:** Expert
- **Salary:** $175,000.0 - $250,000.0
- **Contract:** Permanent contract
- **Skills:** Microsoft Azure, Information Engineering, Data Stores, Python (Programming Language), PostgreSQL, Message Passing Interface, Public Switched Telephone Networks, Queueing Systems, Redis, Data Streaming, Twilio, WebSocket, WebRTC, Flexi (Photoshop Plugin), Large Language Models, Multi-Agent Systems, Concurrency, Fastapi, Kubernetes, Low Latency, Apache Kafka, OPUS (Software), Amazon Simple Queue Service (SQS), Terraform, Dynatrace, Web Api, Microservices
- **Published:** September 4, 2026
- **Apply:** https://startup.jobs/senior-backend-engineer-infrastructure-ellipsis-health-8344051

## About the Role

* 4+ years building production back-ends in modern Python.
 * Proven experience with real-time streaming systems-WebRTC, WebSockets,
or gRPC streaming-and proficiency with asyncio, FastAPI, or similar async
frameworks.

 * Deep understanding of concurrency, buffering, audio codecs (Opus, PCM), and
distributed tracing.

 * Solid understanding of AWS/GCP/Azure, including container orchestration
(Kubernetes/EKS/GKE), message queues (Kafka/SQS/Pub/Sub), and IaC
(Terraform).

 * Solid grasp of relational (PostgreSQL) and in-memory (Redis) data stores; able
to model and persist conversational state.

 * Excellent communication skills and a bias for measured, observable, and
continuously deployable software.
Bonus Points:

 * B.S./M.S. in CS, EE, or related fields.
 * Familiarity with voice-agent frameworks,
 * Hands-on with telephony (Twilio, Telnyx), SIP, or PSTN integrations.
 * Experience integrating multimodal inputs (vision, text chat) into voice agents.
 * Familiarity with GPU inference and streaming pipelines.
 * Prior work in regulated industries (healthcare, finance) and comfort preparing for
 * SOC 2 / HIPAA audits., your individual skills, qualifications, and past experience relative to the requirements of

the role.

Background Checks

## Description

* Expand and maintain our real-time voice pipeline: design, implement, and
maintain Python micro-services for conversational AI orchestration-audio
capture, streaming transcription, prompt/LLM logic, synthesis, and playback.

 * Integrate new providers & transports: add plug-ins for emerging ASR, TTS,
LLM, and memory services; wire up WebRTC, SIP, or phone endpoints; build
adapters that allow hot-swapping components without downtime. Build API
endpoints.

 * Deliver ultra-low latency (<500 ms round-trip): profile async pipelines (asyncio,
FastAPI, gRPC), optimize buffering, concurrency, and back-pressure handling.

 * Instrument & observe every hop: emit structured traces (OpenTelemetry),
metrics, and logs for each pipeline stage; define SLOs for first-token latency,
end-to-end latency, and streaming reliability.

 * Harden for production: implement graceful retries, idempotent message
passing, circuit breakers, and HIPAA-compliant security (encryption in transit,
per-tenant isolation, secrets rotation).

 * Collaborate cross-functionally with ML, product, data engineering, and
client-SDK teams to deliver features such as voice cloning, multimodal hand-offs,
and domain-specific memory retrieval.


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