Senior Backend Engineer

Senior Backend Engineer WHY THIS ROLE EXISTS Our client is building AI technology to make healthcare accessible and free for everyone. They are seeking backend engineers to develop scalable infrastructure that supports billions of AI driven consultations while ensuring medical safety and HIPAA compliance. This role is central to delivering reliable and secure systems at massive scale. WHAT YOU WILL BUILD Healthcare API Infrastructure

• Design and maintain high performance APIs using Python and cloud services to handle millions of requests each month
• Develop RESTful APIs that support AI healthcare tools and internal platform workflows
• Process sensitive patient data in real time while maintaining strict HIPAA compliance

• Coordinate internal APIs to support web platforms and AI decision making Integration and Data Systems

• Implement secure health record exchange with EHR systems, national health networks, and QHINs
• Integrate with telehealth providers, analytics platforms, and third-party healthcare APIs
• Process large volumes of sensitive data with encryption and compliance safeguards

• Build partner API integrations across multiple diverse healthcare systems Scale and Reliability

• Optimize databases for high-volume, complex healthcare queries
• Implement secure caching and session management using Redis
• Develop error handling, failover, and disaster recovery systems for mission critical services

• Enhance performance and reliability to support rapid user growth AI System Integration

• Coordinate backend workflows for AI tools and clinical decision making
• Develop Python-based deterministic systems alongside AI agents to ensure clinical accuracy
• Build APIs supporting model inference, data preprocessing, and result handling

• Implement validation layers and human escalation protocols for AI safety This role also includes work on healthcare compliance automation, advanced system monitoring, multi-region deployment, and foundational backend infrastructure for future AI healthcare capabilities. HOW THE CLIENT OPERATES

• Engineering led environment with minimal process overhead
• Flat structure with direct collaboration with company leadership
• End to end ownership from concept to production
• AI assisted development tools encouraged
• Fast moving team with strong judgment and accountability

• Computer science degree or equivalent hands on experience
• Engineering, math, or related technical degrees welcomed
• Track record of operating at a high engineering standard
• Founder level ownership mindset or early stage startup experience preferred

• Ability to work independently while collaborating across teams Technical Experience

• Six or more years of backend engineering experience
• Strong experience with Python and frameworks such as FastAPI or Flask
• Cloud services experience and high volume API handling
• Proficiency with relational databases and performance optimization

• Experience with Redis, caching strategies, and distributed systems design System Design and Integration

• Third-party API integration and webhook management
• Microservices architecture and distributed system patterns
• Security best practices for sensitive data and API design
• CI/CD pipelines, containerization, and deployment automation

• Monitoring, logging, and observability tools NICE TO HAVE

• Experience in healthcare, fintech, or other regulated industries
• Knowledge of healthcare data standards such as HL7, FHIR, and HIPAA compliance
• Experience with high-scale real time data processing
• Familiarity with AI and ML system integration and model serving
• Event-driven architectures, message queues, and async processing
• Exposure to healthcare workflows, EHR systems, or telehealth platforms
• Seed or Series A startup experience
• Advanced degree in CS, engineering, or related field

Competitive compensation and meaningful equity Opportunity to build infrastructure impacting millions of patients globally Direct collaboration with company leadership and healthcare experts Access to modern backend and AI technologies Benefits reimbursement

• Locations San Francisco, CA * New York, NY