> Markdown version of [/jobs/ext/4608715-senior-backend-engineer-ai-system-integration](https://www.wearedevelopers.com/jobs/ext/4608715-senior-backend-engineer-ai-system-integration). Every page supports `.md` or `Accept: text/markdown`. Links point to the HTML versions so they work for humans too. Agent guide: [/agents.md](https://www.wearedevelopers.com/agents.md).

---

# Senior Backend Engineer, AI System Integration

- **Company:** NxT Level
- **Location:** San Francisco, CA, United States
- **Experience:** Expert
- **Salary:** $180,000.0 - $240,000.0
- **Contract:** Permanent contract
- **Skills:** Application Programming Interfaces (APIs), Artificial Intelligence, Systems Engineering, Software Debugging, Medical Software, Python (Programming Language), MariaDB, Redis, Next.js, SQLAlchemy, TypeScript, ReactJS, Fast Healthcare Interoperability Resources, AI Coding Agents, Backend, AWS ECS, Fastapi, Kotlin, Build Tools, Celery, Front End Software Development, Docker
- **Published:** November 6, 2026
- **Apply:** https://www.adzuna.com/details/5937925122

## About the Role

* Experience shipping user-facing products across frontend and backend systems
 * Strong skills in at least one part of the stack, with the ability to work effectively across the rest
 * Good product judgment and strong attention to interface quality
 * Ability to define and deliver solutions when requirements are incomplete
 * Daily experience directing coding agents
 * Ability to provide context to agents, split work effectively, verify outputs, and know when to work directly
 * Habit of turning manual engineering work into scripts, tools, or reusable agent workflows
 * Sound judgment around privacy, security, accessibility, reliability, and maintainability
 * Clear communication across clinical, product, design, AI, and operations teams
 * Strong ownership and comfort operating in a high-autonomy engineering environment

Many candidates will have 5+ years of professional experience. Our client cares more about the products you have shipped and your role in shipping them than a specific degree or exact tool match.

Bonus Experience

 * Experience in healthcare, fintech, AI products, or another regulated industry
 * Experience building patient-facing, clinician-facing, or partner-facing healthcare software
 * Experience with telehealth systems, healthcare APIs, FHIR workflows, or clinical operations
 * Experience improving coding-agent workflows, automation, or AI-assisted engineering systems
 * Experience working in small, senior engineering teams with high ownership

Production Stack

Relevant technologies include:

 * Next.js
 * React
 * TypeScript
 * Swift
 * Kotlin
 * Python
 * FastAPI
 * MariaDB
 * SQLAlchemy
 * Redis
 * Celery
 * Docker
 * AWS ECS
 * AI provider integrations
 * Telehealth systems
 * Healthcare APIs
 * FHIR-based workflows

Experience with every part of the stack is not required. The right candidate should be able to learn unfamiliar systems and ship across product and backend code., The ideal candidate is a senior full-stack product engineer who wants to build real healthcare products used by real patients and clinicians.

They are product-minded, technically strong, comfortable across the stack, and AI-native in how they work. They can own ambiguous problems, ship complete features, use coding agents effectively, and maintain strong judgment around safety, privacy, reliability, and user experience.

This person does not want to sit in a narrow frontend or backend lane. They want to own the outcome.

## Description

Our client is hiring a Senior Product Engineer, Full Stack to build and ship features across the entire product.

This is not a frontend-only or backend-only role. Product engineers are expected to own complete features across the stack. A project may include a patient workflow in Next.js, a FastAPI endpoint, a new data model, and changes to how a service runs in production.

The team works AI-natively. Coding agents are part of daily delivery, not an occasional assistant. Engineers use agents to explore code, plan changes, implement, test, review, debug, and automate repeated work - while remaining responsible for product decisions, system design, and correctness.

What You'll Do

 * Build patient experiences across onboarding, AI consultations, health records, prescriptions, physician visits, and follow-up care
 * Connect AI consultations with clinical workflows so patients can move from guidance to treatment
 * Turn new clinical and AI capabilities into clear product features with appropriate safeguards
 * Build tools and integrations for clinicians and healthcare partners
 * Work across frontend, backend, data models, APIs, and production infrastructure
 * Improve performance, accessibility, privacy, and reliability across web and mobile experiences
 * Use coding agents to run parallel investigations, shorten the path from idea to production, and automate repeated engineering work
 * Review product usage and customer feedback after launch, then improve the feature
 * Partner closely with clinical, product, design, AI, operations, and engineering teams
 * Own projects from initial definition through launch and production support