Senior Backend Engineer

Job Description

Job Description

Backend Engineer (AI Healthcare Platform)

Location : New York City | Employment : Full-Time | Dept. : Engineering

Compensation : Competitive base + significant equity (seed-stage)

Overview

Seeking a skilled Backend Engineer to build and scale the infrastructure behind an AI healthcare platform serving millions of patients. This role sits at the intersection of high-scale backend engineering and AI systems—owning secure APIs, distributed services, and data pipelines that power 14M+ patient interactions with uncompromising reliability and healthcare compliance.

What You'll Build

Healthcare API Infrastructure

High-throughput Python / FastAPI services on AWS to handle millions of daily requests

RESTful APIs for a growing suite of AI healthcare tools and internal coordination systems

Real-time processing of sensitive PHI with HIPAA-compliant controls

Internal API architecture supporting web clients and AI orchestration

Integration & Data Systems

Secure health record exchange with EHRs, QHINs , and major healthcare networks

Third-party integrations (telehealth, analytics, healthcare APIs)

Large-scale, encrypted data pipelines with compliance guardrails

Partner API integrations across diverse, well-documented healthcare systems

Scale & Reliability Architecture

Database design and optimization (complex query patterns on high-volume healthcare data)

Redis for secure caching / session management in regulated environments

Robust error handling, automated failover, and disaster recovery

Performance tuning and horizontal scaling for rapid user growth

AI System Integration

Backend coordination that guides AI tools and clinical decision workflows

Deterministic Python systems running alongside AI agents for clinical accuracy

APIs for model inference, preprocessing, and result handling

Infrastructure for AI safety (validation layers, human-in-the-loop escalation)

You'll also contribute to compliance automation, advanced monitoring / observability, multi-region deployments, and the backend foundation for next-gen AI healthcare features.

Required Qualifications

Education & Background

CS degree or exceptional equivalent experience (Engineering / Math welcome)

Startup DNA : founder / founding engineer or deep early-stage experience preferred

Proven independence solving complex problems and strong cross-functional collaboration

Technical Expertise

5+ years backend engineering with Python and API development

Strong with FastAPI / Flask (or similar) and cloud services (AWS / GCP / Azure)

Built / scaled RESTful APIs for high-volume traffic

Proficient with relational DBs ( PostgreSQL / MySQL ) and performance tuning

Knowledge of Redis , caching strategies, and distributed systems design

System Design & Integration

Third-party API integrations, webhooks, and microservices patterns

Security best practices for sensitive data and API design

CI / CD, containers ( Docker ), and deployment automation

Monitoring / logging / observability (metrics, tracing, alerts)

Preferred Qualifications

Experience in healthcare, fintech, or other regulated domains

Familiar with HL7, FHIR , and HIPAA requirements

High-scale data processing and real-time systems

Background with AI / ML systems and model serving

Message queues, event-driven, and async architectures

Knowledge of healthcare workflows, EHRs, or telehealth platforms

Seed / Series A startup experience

Advanced degree in CS / Engineering (or related)

What We Offer

Competitive salary + meaningful equity (seed-stage, top-tier investors)

Direct impact on healthcare access for millions of patients

High autonomy, technical leadership, and direct line to the CEO

Access to cutting-edge tech and resources to solve complex scaling challenges

Collaboration with leading AI engineers and healthcare technologists

Benefits reimbursement