Senior Backend Engineer (Community)

Papa•San Francisco, CA

4d•$160,000 - $210,000•Hybrid

About The Position

Papa is building Papa Community, a new virtual care venture for seniors based in San Francisco. As an early member of the founding engineering team, you will have the opportunity to shape the platform's technical architecture, system design, and engineering practices. This role offers the autonomy of an early-stage startup with the stability of a growth-stage company. You will own problems, partner directly with the GM, and leverage Papa's infrastructure while maintaining startup velocity. The role involves navigating complex healthcare integrations, balancing technical perfection with shipping velocity, and working in a high-autonomy environment with open questions and evolving processes.

Requirements

6+ years of software development experience
Strong proficiency in Ruby on Rails or Python
1+ years of hands-on experience with Elixir
Experience building and shipping high quality work and achieving high reliability
Experience improving quality through thoughtful code reviews, appropriate testing, proper rollout, and monitoring
Passionate about improving healthcare access and outcomes
Genuine appetite for ambiguity and ownership; energized by open questions and evolving standards.
Bias toward velocity; want to ship, see it working, and iterate.
Product mindset; think like a founder, balancing technical excellence with business outcomes, revenue, and patient impact.
Independent ownership of the full lifecycle of features and projects - design, development, deployment, and monitoring.
Strong backend expertise: Solid understanding of distributed systems, API design, and scalable architecture.
System design and reliability: Build resilient, well-tested systems with proper monitoring, rollout practices, and production stability for healthcare-critical workloads.
High autonomy and ownership: Thrive in ambiguous environments, educate non-technical stakeholders, and own outcomes without needing detailed requirements or constant direction.
Startup adaptability: Highly communicative across operational and clinical teams, move fast when needed, and understand when to ship quickly versus architect for scale.
Continuous improvement mindset: Proactively identify areas for improvement in systems and processes without being asked, and drive initiatives to address them.

Nice To Haves

Experience working as one of the first engineers at an early-stage startup, or otherwise building without an established engineering org around you
Deeper Elixir expertise, including Phoenix LiveView
Experience with healthcare technology including data standards (FHIR, HL7, X12), EHR/vendor integrations, HIPAA-compliant systems for protected health information, and healthcare-specific APIs (clearinghouses, billing platforms)

Responsibilities

Build and scale Papa Community's proprietary platform, the operational backbone for the care team.
Strengthen the revenue cycle management pipeline, including integration and improvement of RCM vendor relationships, claims data pipelines, denial handling, and patient responsibility workflows.
Extend platform and tooling investments, including transactional email, customer support tooling, and member- and internal-facing systems.
Enable operational intelligence and automation by building data infrastructure and tooling for informed decision-making, workflow automation, and real-time patient outcome tracking.
Contribute to critical technical decisions, including build vs. buy trade-offs and technology choices, in partnership with Staff Engineers and the GM.
Support engineering practices as the team grows, including maintaining code standards, testing expectations, deployment processes, and technical documentation.
Own system reliability and performance for built areas, ensuring resilient systems for healthcare-critical workflows like claim submissions, patient data accuracy, and care coordination.