Senior Backend EngineerOur client is building AI technology to make healthcare accessible and free for everyone. They are seeking backend engineers to develop scalable infrastructure that supports billions of AI driven consultations while ensuring medical safety and HIPAA compliance.This role is central to delivering reliable and secure systems at massive scale.Healthcare API InfrastructureDesign and maintain high performance APIs using Python and cloud services to handle millions of requests each monthDevelop RESTful APIs that support AI healthcare tools and internal platform workflowsProcess sensitive patient data in real time while maintaining strict HIPAA complianceCoordinate internal APIs to support web platforms and AI decision makingIntegration and Data SystemsImplement secure health record exchange with EHR systems, national health networks, and QHINsIntegrate with telehealth providers, analytics platforms, and third-party healthcare APIsProcess large volumes of sensitive data with encryption and compliance safeguardsBuild partner API integrations across multiple diverse healthcare systemsScale and ReliabilityOptimize databases for high-volume, complex healthcare queriesImplement secure caching and session management using RedisDevelop error handling, failover, and disaster recovery systems for mission critical servicesEnhance performance and reliability to support rapid user growthAI System IntegrationCoordinate backend workflows for AI tools and clinical decision makingDevelop Python-based deterministic systems alongside AI agents to ensure clinical accuracyBuild APIs supporting model inference, data preprocessing, and result handlingImplement validation layers and human escalation protocols for AI safetyThis role also includes work on healthcare compliance automation, advanced system monitoring, multi-region deployment, and foundational backend infrastructure for future AI healthcare capabilities.Engineering led environment with minimal process overheadFlat structure with direct collaboration with company leadershipEnd to end ownership from concept to productionAI assisted development tools encouragedFast moving team with strong judgment and accountabilityBackgroundComputer science degree or equivalent hands on experienceEngineering, math, or related technical degrees welcomedTrack record of operating at a high engineering standardFounder level ownership mindset or early stage startup experience preferredAbility to work independently while collaborating across teamsTechnical ExperienceSix or more years of backend engineering experienceStrong experience with Python and frameworks such as FastAPI or FlaskCloud services experience and high volume API handlingProficiency with relational databases and performance optimizationExperience with Redis, caching strategies, and distributed systems designSystem Design and IntegrationThird-party API integration and webhook managementMicroservices architecture and distributed system patternsSecurity best practices for sensitive data and API designCI/CD pipelines, containerization, and deployment automationMonitoring, logging, and observability toolsNice to HaveExperience in healthcare, fintech, or other regulated industriesKnowledge of healthcare data standards such as HL7, FHIR, and HIPAA complianceExperience with high-scale real time data processingFamiliarity with AI and ML system integration and model servingEvent-driven architectures, message queues, and async processingExposure to healthcare workflows, EHR systems, or telehealth platformsSeed or Series A startup experienceAdvanced degree in CS, engineering, or related fieldCompetitive compensation and meaningful equityOpportunity to build infrastructure impacting millions of patients globallyDirect collaboration with company leadership and healthcare expertsAccess to modern backend and AI technologiesBenefits reimbursement