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# Founding Backend & Infrastructure Engineer

- **Company:** True Talent Solutions LLC
- **Location:** San Francisco, CA, United States
- **Experience:** Experienced
- **Salary:** $160,000 - $200,000
- **Contract:** Permanent contract
- **Skills:** Artificial Intelligence, Hospital Information Systems, Data Infrastructure, Distributed Systems, Web Browsers, Python (Programming Language), Machine Learning, Operational Data Store, Software Engineering, Systems Integration, Workflow Management Systems, Large Language Models, Electronic Medical Records, Backend, Information Technology, Data Pipelines, Microservices
- **Published:** November 12, 2026
- **Apply:** https://www.careerbuilder.com/job-details/founding-backend-infrastructure-engineer-san-francisco-ca--8dbb22af-9d19-4921-9511-c77cc9ec4d3e

## About the Role

Healthcare, Artificial Intelligence (AI), Production Systems, Team Building, Clinical Information Systems, Distributed Computing, Claims Processing, Automation, Medical Record System, Web Browsers, * 3 or more years of backend software engineering experience, with a focus on infrastructure and complex systems.

 * Strong Python, microservices, and distributed systems experience, with a track record of owning backend systems end to end.
 * Experience scaling systems at a technically complex organization, such as in data infrastructure, fintech, or healthtech.
 * Production experience with LLMs or machine learning models.
 * Experience with data pipelines, workflow orchestration, large or messy datasets, browser automation, or complex integrations.
 * A degree in computer science, mathematics, or a related field, or equivalent strong technical fundamentals.
 * Interest in hands-on work at an early-stage startup, with a willingness to contribute code day to day.
 * Must be authorized to work in the United States without visa sponsorship.

## Description

Join an early-stage healthtech team building clinical AI systems for healthcare payments. You will own core backend infrastructure that processes complex clinical and financial workflows, helping bring new capabilities into reliable production systems., * Build and scale distributed backend systems for chart processing, claims, authorizations, denials, and payer and provider integrations.

 * Develop browser and computer-use automation to navigate medical record software and payer portals.
 * Design reliable systems to process scanned charts, PDFs, structured claims, unstructured notes, and operational data at scale.
 * Build orchestration, queuing, retry, and observability infrastructure for long-running workflows across healthcare systems.
 * Partner with research and product engineers to put clinical intelligence capabilities into production and establish engineering patterns.