Principal Backend Engineer

Qualified Health PBC•Palo Alto, CA

5d•Hybrid

About The Position

Qualified Health is seeking a Principal Backend Engineer to shape the technical direction and architecture of its generative AI healthcare SaaS platform. As a senior individual contributor, this person will lead the design and evolution of critical backend systems, address complex technical challenges, and establish foundations for reliable and secure growth. The role partners with engineering, product, AI, and security leadership to turn business priorities into long-term technical strategy and drive high-impact initiatives across teams. This is a hands-on technical leadership role, combining direct work on difficult engineering problems with raising engineering standards, mentoring engineers, and shaping the technical culture. The engineer will guide scalable, secure, and reliable backend architecture; lead cross-team initiatives from design through production; and balance rapid innovation with operational excellence. The position requires working on-site at the Palo Alto office three days per week and offers hybrid work options.

Requirements

Demonstrated track record architecting, building, and operating complex, large-scale backend or platform systems in production, with measurable technical and business impact.
Deep expertise in distributed systems, including service architecture, data consistency, concurrency, fault tolerance, scalability, and performance optimization.
Expert-level proficiency in at least one modern backend programming language and willingness to work extensively in Python.
Strong experience designing and operating cloud-native applications on AWS, GCP, or Azure, including understanding of infrastructure automation, deployment practices, and production operations.
Deep understanding of API design, data modeling, databases, asynchronous processing, and modern backend architectural patterns.
Ability to navigate ambiguity, independently identify important technical problems, and translate complex requirements into pragmatic, scalable engineering solutions.
Demonstrated ability to improve engineering effectiveness through architectural simplification, reusable systems, mentorship, and technical standards.
Ability to work on-site in the Palo Alto office three days per week.

Nice To Haves

Experience designing, building, or operating production generative AI applications, LLM-powered workflows, or AI infrastructure.
Experience building multi-tenant enterprise SaaS platforms with strong security, isolation, scalability, and availability requirements.
Experience with Google Cloud Platform, Kubernetes, Terraform, and modern monitoring and observability tooling.
Experience building systems in regulated environments, including healthcare, financial services, or other industries with stringent data privacy and security requirements.
Familiarity with HIPAA, SOC 2, or comparable security and compliance frameworks.
Experience establishing technical foundations, engineering standards, and architectural direction in rapidly growing organizations.

Responsibilities

Define and drive long-term technical direction for core backend systems and services.
Establish architectural principles and guide technology decisions that support scalability, security, reliability, and sustainable growth.
Identify and lead complex engineering initiatives across multiple teams, building alignment, resolving architectural disagreements, and driving work from design through production operation.
Design, implement, and review critical backend infrastructure components, leading by example with high-quality code and thoughtful system design.
Foster an AI-first culture.
Architect resilient distributed systems, APIs, data services, and asynchronous workflows for growing enterprise workloads, complex integrations, and evolving product requirements.
Establish engineering practices that improve reliability, observability, performance, and operational efficiency.
Partner with Platform and Infrastructure teams on service-level objectives, capacity planning, incident prevention, and systemic improvements.
Mentor Senior and Staff engineers and develop emerging technical leaders.
Foster technical rigor, collaboration, ownership, and continuous improvement.
Collaborate with engineering, product, and business leadership to evaluate technical investments, make build-versus-buy decisions, manage architectural trade-offs, and balance near-term delivery with long-term platform sustainability.