Sr/Staff Backend Engineer

FYT • San Francisco, CA

7d • Onsite

About The Position

Our client is an AI-driven platform that makes healthcare more accessible by connecting patients to the right providers, offering transparent pricing, and simplifying medication management. We're looking for a senior backend engineer to join a high-growth health tech company, where a small, elite team powers a large-scale platform serving hundreds of thousands of patients. You'll own core systems end-to-end — from clinical approval workflows and multi-pharmacy fulfillment routing to subscription billing and partner integrations — designing the schema, writing business logic, deploying to Kubernetes, and owning observability in production. If you're drawn to deep domain complexity, real autonomy, and work that directly shapes patient outcomes across an expanding range of care offerings, this is the role.

Requirements

• 5–7+ years of backend engineering experience operating production systems with real complexity — not just high traffic, but distributed stateful workflows, complex domain logic, and deep third-party integrations.
• Proficiency in data modeling, schema design, state transitions, and domain boundaries.
• Comfortable with, or eager to master, Kubernetes, Terraform, AWS, and CI/CD.
• Experience deploying code and owning its reliability in production.
• Actively use frontier agentic tools to build faster and can speak concretely about how they've shifted your workflow — while maintaining the technical rigor to audit and own everything they produce.
• Low-ego, high-standards, and communicate well across functions.
• Comfortable working where engineering decisions are shaped by compliance, regulation, and patient safety.
• For Staff-level candidates: a track record of setting technical direction, operating in ambiguity, and measurably growing the engineers around you.

Nice To Haves

• Familiarity with TypeScript, Node.js, Express, PostgreSQL, Redis, Kubernetes, Terraform, AWS.

Responsibilities

• Build and evolve subscription and billing infrastructure that handles the real complexity of healthcare commerce — mid-cycle medication changes, dynamic pricing across pharmacy partners, payment recovery, and prorated billing.
• Own the systems powering medication ordering and fulfillment: reliable pipelines that handle compounding pharmacy integrations, controlled substance compliance, and personalized dosing protocols across a distributed network of external partners.
• Take hands-on ownership of AWS and Kubernetes infrastructure — establishing CI/CD pipelines, building observability, and creating deployment patterns that let the entire team ship quickly and safely.
• Work directly with Clinical, Operations, and Product teams to shape what gets built. Evaluate proposed workflows, take ownership of business outcomes, and find the most efficient paths to patient value.
• Design backend architecture that enables AI-assisted agents to automate clinical operations, improve patient safety, and scale provider workflows — while also using agentic tools to accelerate your own development.
• Raise the engineering bar through key architectural decisions, systematic modernization of legacy systems, rigorous code review, and mentorship of the engineers around you.

What This Job Offers

• Job Type: Full-time
• Career Level: Senior
• Education Level: No Education Listed