Backend Engineer

About the Role

Join a tight-knit, six-person engineering team at an early-stage AI-native healthtech startup that is building the agentic command center for healthcare administration — with a laser focus on eliminating the burden of administrative clinical tasks. You'll help develop the backend systems that power patient access to care and drive the company's primary growth lever: rapid customer onboarding. The work is high-impact, patient-facing, and spans secure processing of clinical information at scale.

This is a full-time, on-site role (five days per week) in San Francisco, CA. Visa sponsorship is available.

What You'll Do

• Architect and deploy AI-native backend systems that process high-volume clinical data via API.

• Shape upcoming product iterations end-to-end by integrating direct customer feedback into the development cycle.

• Build reliable, secure agentic infrastructure capable of handling clinical information for millions of patients.

• Own and evolve critical backend infrastructure, driving its technical direction.

• Scale systems and architecture to support rapid customer onboarding and company growth.

What We're Looking For

Must-haves:

• 5+ years of software engineering experience building and delivering production-grade systems.

• Proficiency in at least one systems programming language: C, C++, Rust, or Go.

• Experience designing and implementing scalable backend systems or infrastructure.

• Strong proficiency in Python.

• Infrastructure-as-code experience with Terraform or a comparable tool.

• Understanding of prompt engineering and working with LLMs.

• Experience with distributed systems concepts (consensus, replication, fault tolerance).

• Experience with database systems or data storage technologies.

• Solid Git/version control practices with a strong GitHub contribution profile showing active, meaningful commits.

• Experience with performance optimization and profiling of backend systems.

• Currently employed at an established company.

• Ability to work on-site five days per week in San Francisco.

• Genuine passion for building impactful products in healthcare.

Nice to have:

• Experience with cloud platforms (AWS, GCP, or Azure) and/or containerization (Docker, Kubernetes).

• Contributions to open source projects or public repositories.

• Experience with testing frameworks and writing automated tests.

Compensation & Benefits

• Salary: $120,000 – $250,000 per year, depending on experience.

• Visa sponsorship available.

Location

On-site, five days per week in San Francisco, CA. The primary hiring location is the Los Angeles, CA metro area, with additional consideration for candidates in New York City and San Francisco.