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