Software Engineer - Core Systems

Recruiting From Scratch • San Francisco, CA

4d • Onsite

About The Position

Our client is an early-stage, VC-backed healthcare technology company building AI-powered infrastructure to improve medical imaging and diagnostic workflows. The company is developing a healthcare platform that combines medical imaging, software infrastructure, and AI to help healthcare providers address significant capacity and workflow challenges. The engineering team is small and highly autonomous, giving engineers substantial ownership over foundational infrastructure. The platform handles large-scale medical imaging data and connects with existing healthcare systems and workflows. The engineering challenges span data ingestion, data warehousing, distributed systems, model inference, cloud infrastructure, deployment automation, observability, security, and healthcare integrations. This is an opportunity for a senior engineer to own core backend infrastructure end-to-end and work closely with ML engineers and other technical leaders to build reliable systems in a highly regulated environment.

Requirements

• 6+ years of professional software engineering experience.
• 5+ years preferred in data infrastructure, backend engineering, or distributed systems.
• Strong experience building and operating production backend infrastructure.
• Experience working with distributed systems and high-volume data pipelines.
• Experience owning systems end-to-end in production.
• Demonstrated ability to operate autonomously without heavy management.
• Experience working in strong engineering environments with high standards for infrastructure quality.
• Experience at a startup, high-growth technology company, or similarly high-ownership engineering environment is strongly preferred.
• Comfortable working as part of a small engineering team where engineers own broad areas of the stack.
• Strong production experience with Python and/or Go.
• Strong backend engineering fundamentals.
• Experience designing distributed systems.
• Experience building data pipelines and ETL infrastructure.
• Experience with data warehousing systems.
• Strong AWS experience.
• Experience with Docker and modern deployment infrastructure.
• Experience building CI/CD pipelines and deployment automation.
• Strong understanding of production reliability and infrastructure operations.
• Experience with observability, logging, monitoring, and debugging.
• Experience with relational and/or analytical data systems.
• Strong understanding of distributed systems architecture.
• Experience designing reliable data ingestion pipelines.
• Experience processing large datasets or high-throughput workloads.
• Experience with asynchronous processing and distributed workloads.
• Understanding of system reliability, fault tolerance, and failure recovery.
• Experience with capacity planning and infrastructure scaling.
• Experience supporting machine learning infrastructure or model inference is strongly preferred.
• Experience working with cloud-based infrastructure at production scale.
• Understanding of ETL/ELT patterns and data lifecycle management.
• Experience integrating multiple backend services and infrastructure components.
• Experience designing secure production systems.
• Understanding of encryption, authentication, authorization, and access controls.
• Experience working with sensitive or regulated data is strongly preferred.
• Highly autonomous and comfortable operating without heavy management.
• Strong ownership mentality.
• Excellent debugging and problem-solving skills.
• Strong engineering judgment and attention to infrastructure quality.
• Comfortable working across backend, data, infrastructure, and ML systems.
• Able to prioritize effectively in a small, fast-moving team.
• Strong communication and collaboration skills.
• Comfortable working through ambiguous technical problems.
• Pragmatic and focused on building reliable systems rather than over-engineering.
• Comfortable taking responsibility for systems after they reach production.

Nice To Haves

• TypeScript experience is a plus.
• React experience is a plus.
• Familiarity with HIPAA or other healthcare security/compliance requirements is a plus.
• Experience integrating with healthcare systems or medical data is a plus.
• Familiarity with healthcare interoperability standards such as DICOM or HL7 is a plus.

Responsibilities

• Build Core Backend & Data Infrastructure: Design, build, and operate core backend infrastructure end-to-end. Build scalable data ingestion pipelines and ETL systems for large volumes of medical imaging data. Design and maintain data warehousing infrastructure supporting analytics and machine learning workloads. Build backend services and distributed systems running on AWS. Design systems that can reliably process, store, and distribute large datasets. Continuously improve architecture, scalability, performance, and maintainability.
• Build Distributed Inference & ML Infrastructure: Collaborate closely with ML engineers to support production model inference workflows. Build infrastructure for distributed model inference and AI-powered processing pipelines. Design reliable systems for moving data between ingestion, processing, storage, and inference layers. Support evolving ML infrastructure requirements as models and workloads scale. Help bridge the gap between backend engineering and machine learning infrastructure.
• Own Reliability, Observability & Infrastructure: Own reliability and operational performance across the backend stack. Build monitoring, logging, alerting, and debugging systems. Identify and resolve production issues across distributed services and data pipelines. Lead capacity planning and infrastructure improvements as system usage grows. Build CI/CD and deployment automation that enables a lean engineering team to ship safely and quickly. Take responsibility for systems in production without relying on a separate SRE organization.
• Build Secure & Compliant Healthcare Systems: Design systems handling protected health information (PHI) with security and compliance built in from the beginning. Implement appropriate encryption, access controls, authentication, authorization, and audit logging. Build infrastructure that supports HIPAA-compliant data handling and operational practices. Work closely with engineering and product stakeholders to identify and mitigate infrastructure and security risks. Design reliable integrations with healthcare systems and data workflows as the platform expands.

Benefits

• $215,000 – $275,000 base salary, depending on experience.
• Competitive equity.
• Full-time employment.
• On-site work in San Francisco, 5 days per week.
• Visa transfers supported, including OPT and H-1B transfers.
• Visa sponsorship supported, including new H-1B and TN where applicable.
• Opportunity to work directly on foundational infrastructure at an early-stage healthcare technology company.
• Significant technical ownership within a small engineering team.

What This Job Offers

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