Senior Backend Engineer, Workflow Systems

Kinstead•New York, NY

18d•Hybrid

About The Position

Kinstead is seeking a senior backend engineer to build and own core backend systems and application logic. The role involves designing and building services that power reliable clinical and operational workflows, including APIs, background processing, and system behavior under real-world conditions. The focus is on reliability, correctness, and predictable execution as the product grows. Prior healthcare or FHIR experience is not required; strong backend fundamentals, sound engineering judgment, and the ability to quickly learn a complex domain are prioritized. The engineer will work closely with the CTO on system design while maintaining ownership of implementation and operational correctness. Kinstead heavily utilizes AI development tools like Claude Code, GitHub Copilot, and Codex to accelerate development, with engineers expected to understand system behavior, review generated code, debug failures, and maintain high standards for reliability, security, and production quality. Engineers are expected to own their code end-to-end, even when using AI assistance, and participate in team code reviews to maintain system-wide context.

Requirements

5+ years building production software systems
Strong Python experience
Familiarity with asynchronous programming in any language
Experience designing and maintaining APIs for production applications
Experience building backend systems beyond request/response — background jobs, event-driven patterns, or async processing
Strong debugging and problem-solving skills
Ability to design systems that behave predictably when things go wrong
Comfort working in an AI-assisted development workflow

Nice To Haves

Experience with React or NextJS
Experience building workflow or state-machine-driven systems
Experience reasoning about stateful systems
Experience with FHIR or healthcare data systems (helpful but not required)
Experience with Kubernetes or distributed systems
Experience working in early-stage startups

Responsibilities

Design and implement backend workflows and application logic
Build and maintain APIs that power product functionality
Implement scheduling, encounter, and operational workflows
Build AI-powered tools that help clinicians with documentation, clinical decision support, and voice-driven workflows
Integrate with clinical systems using FHIR
Debug and resolve production issues across the stack
Ensure system behavior remains predictable under failure conditions
Collaborate with frontend engineers to maintain clear API contracts
Use AI development tools to accelerate implementation while maintaining reliability
Participate in system design and technical planning