Senior/Staff Software Engineer

Heartflow•San Francisco, CA

5h•Hybrid

About The Position

Heartflow is a medical technology company advancing the diagnosis and management of coronary artery disease, the #1 cause of death worldwide, using cutting-edge technology. The flagship product—an AI-driven, non-invasive cardiac test supported by the ACC/AHA Chest Pain Guidelines called the Heartflow FFRCT Analysis—provides a color-coded, 3D model of a patient’s coronary arteries indicating the impact blockages have on blood flow to the heart. Heartflow is the first AI-driven non-invasive integrated heart care solution across the CCTA pathway that helps clinicians identify stenoses in the coronary arteries (RoadMap™Analysis), assess coronary blood flow (FFRCT Analysis), and characterize and quantify coronary atherosclerosis (Plaque Analysis). Our pipeline of products is growing and so is our team; join us in helping to revolutionize precision heartcare. Heartflow is a publicly traded company (HTFL) that has received international recognition for exceptional strides in healthcare innovation, is supported by medical societies around the world, cleared for use in the US, UK, Europe, Japan and Canada, and has been used for more than 750,000 patients worldwide. We are seeking a Senior or Staff Software Engineer to design, build, and operate the backend services behind our clinical platform — the systems that move patient imaging data through our AI analysis pipeline and deliver results to clinicians around the world. We are looking for an engineer who takes end-to-end ownership of their work, from design through production, and who holds a high bar for correctness and security because there is a patient on the other side of every case. You will work with complex medical data in a regulated environment, where design controls and traceability are part of how we build, not a step at the end. This posting covers two levels. As a Senior Software Engineer, you will own the design and delivery of significant features and services within a team. As a Staff Software Engineer, your scope extends beyond a single team — you will lead multi-quarter technical initiatives that span services and teams, and act as a force multiplier for the engineers around you. We will calibrate level based on your experience and the interview process.

Requirements

Bachelor’s degree in Computer Science, Engineering, or related discipline, or equivalent experience
7+ years of professional software engineering experience for the Senior level; 10+ years, including demonstrated technical leadership beyond a single team, for the Staff level
Strong backend programming skills in Python or Java, with solid fundamentals in object-oriented programming, data modeling, concurrency, and API design
Hands-on experience building and operating services on a cloud platform (AWS), and working knowledge of both SQL and NoSQL data stores
Demonstrated experience designing, shipping, and operating production services in a distributed or microservices architecture
Track record of owning a meaningful service or component end to end, including its reliability and performance in production
Disciplined approach to automated testing, code review, and debugging; you can explain why your code is correct, not only that it works
Experience with Agile development methodologies and project management tools
Working knowledge of web and OWASP security best practices
Hands-on experience with AWS services (Lambda, ECS, EKS, Fargate, S3, SQS, VPC), infrastructure-as-code tooling (Terraform, CDK), CI/CD, and observability
Ability to write and speak clearly about technical work, including to stakeholders outside engineering
Demonstrated ability to work in a fast-paced, collaborative environment

Nice To Haves

Experience with medical imaging data (DICOM), healthcare interoperability standards (HL7, FHIR), or systems that handle PHI
Deep experience with Django and the Django ORM in a production service, including migration strategy and query performance tuning on large datasets
Experience working within a controlled development process — FDA-regulated medical software, or another regulated or safety-critical domain
For Staff-level candidates: a track record as a tech lead or staff engineer driving technical initiatives across multiple teams

Responsibilities

Design, build, test, and operate backend services and APIs for the Heartflow clinical platform, owning your work from design review through production monitoring
Technical Design: Translate product and clinical requirements into clear technical designs; write and review design documents, and reason explicitly about trade-offs among correctness, performance, security, and long-term maintainability
Write high-quality, well-tested code, and hold a high bar in code review — for correctness, readability, and the documentation our regulated environment requires
Build and improve the services and data pipelines that move patient imaging data and analysis results through the platform reliably and securely, at scale
Implement secure-by-default patterns for authentication, authorization, access control, and data integrity, in line with platform-wide security architecture standards
Own reliability and performance for the systems you build: instrument them, set up monitoring and alerting, investigate production issues, and participate in on-call
Contribute to CI/CD pipelines, infrastructure-as-code, and developer tooling that make the whole team faster
Produce the design, verification, and traceability documentation required for FDA-regulated medical software, and build to HIPAA requirements for handling patient data
Mentor engineers through code review, pairing, and design feedback; help onboard new team members and raise the engineering bar around you
AI-Assisted Engineering: Use AI coding assistants or agents in production work, with clear judgment about where they speed you up, where they don’t, and how you verify what they produce
Partner with Product, Clinical, Operations, and Regulatory to scope work, and communicate technical trade-offs clearly to non-engineering stakeholders
Technical Leadership (Staff): Lead technical initiatives that span multiple services and teams — drive the design, align stakeholders, break the work into deliverable milestones, and carry it through to production
Risk and Standards (Staff): Identify technical risk and dependencies early and propose mitigations; help define and evolve engineering best practices, tooling standards, and architecture patterns adopted beyond your immediate team