Senior Backend Software Engineer

Alpaca Health • New York City, NY

1d • Onsite

About The Position

Alpaca Health enables clinicians to become entrepreneurs, starting in autism care. We help clinicians launch and scale their own clinics by providing AI-powered software, payer contracting, and full back-office infrastructure. Our goal is simple: use technology to make business ownership possible for every passionate provider. We've raised over $14M in funding from early-stage investors like Core Innovation Capital, Adverb Ventures, and South Park Commons, and are building for long-term category leadership. More importantly, we're serving hundreds of patients, while growing 30% MoM. This role is full-time. We’re looking for candidates based in New York City or San Francisco, excited about a 5 days in-office culture. Both founders are technical. Every engineer on the team has experience at early-stage startups. Several have built products from zero to scale, and one previously founded a YC-backed company. We care deeply about engineering quality, ownership, and building systems that correctly model reality. We do not have layers of management, architecture committees, or roadmap bureaucracy. Engineers talk directly to customers, make technical decisions, and ship.

Requirements

• Experience building in environments where mistakes matter, whether in fintech, healthcare, insurance, logistics, or another operationally complex domain, working on systems where data integrity, money movement, and business rules couldn't be treated as an afterthought.
• Ability to think in systems, not features. Naturally model states, transitions, invariants, and edge cases when presented with a workflow.
• Enjoy turning messy real-world processes into clean software abstractions.
• Strong product instincts and care about the user experience as much as the implementation.
• Ability to sit with a provider, understand their pain points, and translate them into software that feels simple despite complex underlying logic.
• Thrive in ambiguity; comfortable taking a loosely defined problem, identifying important questions, proposing solutions, and driving execution.
• Operate with high ownership; think of your job as making a problem disappear, solving it regardless of where it falls on the org chart.
• AI-native; actively use AI in your day-to-day workflow and are constantly experimenting with new ways to increase leverage.
• Excited about what software development, operations, and healthcare workflows look like when AI is a first-class primitive rather than an add-on.
• Balance speed with judgment; know when to move fast and when to invest in foundations.
• Ability to build quickly without leaving behind a trail of technical debt.
• Enjoy learning complicated domains like healthcare, with its exceptions, regulations, payer rules, credentialing requirements, and operational edge cases.
• Still love writing code; experienced enough to lead major technical decisions, but haven't lost the desire to build.
• Want to spend time creating products and systems, not managing process.

Nice To Haves

• Experience building AI-powered products in production
• Experience with LLM workflows, agents, evals, or developer tooling
• Experience modeling complex operational or financial systems
• Healthcare, EHR, insurance, or revenue cycle experience
• Experience at an early-stage startup where you owned large parts of the product

Responsibilities

• Build and maintain critical integrations with platforms like Candid, Silna, Availity, HubSpot, payroll providers, and state Medicaid systems, ensuring data flows reliably across the entire Alpaca platform.
• Own the backend systems that power billing, authorizations, eligibility, patient responsibility, payroll, and provider payouts. Design the engines that move millions of dollars through the platform while ensuring accuracy, auditability, and trust.
• Build software and AI-powered workflows that automate credentialing, authorizations, billing operations, compliance, and care coordination, allowing a small team to support thousands of providers.
• Build the data infrastructure that powers reporting across the company. Own the pipelines, models, and backend services that give providers visibility into their businesses and enable internal teams to make operational decisions with confidence.
• Design the systems that power provider compensation, payroll integrations, time tracking, PTO, and workforce operations. Help make getting paid feel seamless for clinicians while ensuring compliance and financial accuracy behind the scenes.
• Own the underlying systems that make everything possible: APIs, data models, event-driven architectures, security, compliance, reliability, and AI infrastructure.
• Think deeply about system design and build products that remain correct as Alpaca scales from hundreds to thousands of providers.

What This Job Offers

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