Staff Backend Engineer

Staff Backend Engineer

Reference: BH-381p

Job Type: Permanent

Location: Remote (US)

Salary: up to $250,000 per annum + bonus

About the company:

They are building an AI-powered care orchestration platform designed to unify fragmented healthcare systems and improve patient outcomes at scale. The platform combines agentic AI workflows with a robust backend infrastructure to automate complex clinical and operational processes.

The product is backed by significant early-stage funding and led by operators with experience scaling healthcare and technology platforms nationally. The focus is on delivering a production-grade, patient-facing AI system that operates reliably in high-stakes environments.

They are looking for staff-level engineers to help design, build, and scale the backend systems that power the platform.

Engineering Culture & Values

They operate as a high-performing engineering team focused on delivering high-quality, impactful systems. Their values include:

• Engineering Excellence: Strong ownership of technical quality, performance, and reliability
• Impact-Driven Development: Building systems that solve real-world problems at scale
• Collaboration Over Ego: Working as a team to deliver meaningful outcomes quickly
• Continuous Growth: Learning, mentorship, and raising the bar across the team

Responsibilities

As a Staff Backend Engineer, you will design, build, and operate highly scalable backend systems that power a complex healthcare orchestration platform. You will own critical platform and infrastructure components across distributed systems, workflow automation, service orchestration, and large-scale data processing systems.

• Design, develop, and operate scalable backend systems and distributed services
• Build and maintain highly scalable, fault-tolerant, event-driven systems in production
• Design and operate large-scale data processing pipelines and workflow systems
• Ensure high performance, low latency, scalability, observability, and reliability across backend systems
• Implement best practices across CI/CD, testing, monitoring, and cloud-native production deployments
• Contribute to platform architecture with a focus on modularity, extensibility, and maintainability
• Integrate backend systems with external platforms, APIs, and operational systems
• Partner with engineering, product, data, and clinical teams to deliver scalable production systems
• Raise the engineering bar through technical leadership, mentoring, standards, and architectural guidance
• Own systems end-to-end, including debugging, incident response, operational excellence, and continuous improvement

Skills & Experience

• Strong experience building complex production backend systems in Python, with a focus on scalability, reliability, and performance
• Proven ability to design and operate highly scalable distributed systems in production
• Deep expertise in event-driven architectures, concurrency (multi-processing, multi-threading, async), and distributed systems design
• Strong experience designing and building distributed services (REST and/or gRPC) and service-oriented architectures
• Experience designing and operating large-scale data processing pipelines and workflow systems
• Strong experience with metrics, observability, monitoring, and production reliability practices
• Experience handling high-throughput systems with low-latency and fault-tolerance requirements
• Experience working with large-scale data processing and analytics systems
• Solid experience with PostgreSQL and data modelling at scale (e.g. multi-tenant systems, performance optimisation)
• Production experience with cloud infrastructure (GCP preferred)
• Strong practices across CI/CD, testing, monitoring, and production operations
• Experience integrating with external systems/APIs in complex production environments
• Demonstrated ability to operate at Staff level, including architectural ownership, technical decision-making, and mentoring engineers

Essential Qualifications

• 8+ years of hands-on experience building and operating production backend systems
• Computer Science or Engineering degree, or equivalent practical experience
• Proven experience designing and operating complex backend systems in production
• Deep understanding of scalability, reliability, and distributed systems patterns
• Experience with async or event-driven architectures
• Strong communication and cross-functional collaboration skills
• Track record of owning and delivering production systems end-to-end

Desirable Qualifications

• Experience building AI-powered or LLM-integrated systems in production
• Experience with workflow orchestration or agentic-style systems
• Experience implementing finite state machines or long-running workflow systems
• Familiarity with AI platforms and tooling (e.g. Vertex AI or similar)
• Experience with AI evaluation, inference, or prompt orchestration systems
• Familiarity with AI-assisted development tools (e.g. Cursor, Claude Code, GitHub Copilot)
• Experience in startup or high-growth environments
• Experience working within healthcare, EHR/EMR, or regulated environments

Location

This role can be remote or onsite, based in New York City or Boca Raton, in a fast-paced, collaborative environment where ideas move quickly from concept to production.

Job Benefits

We offer a comprehensive and competitive benefits package designed to support your well-being and professional growth:

• Generous Paid Time Off (PTO) to support work-life balance
• Comprehensive health, vision, and dental insurance for you and your family
• Life and disability insurance for financial security
• Simple IRA matching to support long-term financial goals
• Professional development budget (conferences, courses, certifications)
• Wellness programs supporting physical and mental health