Sr Backend Engineer
NxT Level•New York, NY
About The Position
Our client is building AI technology to make healthcare accessible and free for everyone. They are seeking Sr Backend engineers to develop scalable infrastructure that supports billions of AI driven consultations while ensuring medical safety and HIPAA compliance. This role is central to delivering reliable and secure systems at massive scale.
Requirements
- Computer science degree or equivalent hands on experience
- Engineering, math, or related technical degrees welcomed
- Track record of operating at a high engineering standard
- Founder level ownership mindset or early stage startup experience preferred
- Ability to work independently while collaborating across teams
- Six or more years of backend engineering experience
- Strong experience with Python and frameworks such as FastAPI or Flask
- Cloud services experience and high volume API handling
- Proficiency with relational databases and performance optimization
- Experience with Redis, caching strategies, and distributed systems design
- Third-party API integration and webhook management
- Microservices architecture and distributed system patterns
- Security best practices for sensitive data and API design
- CI/CD pipelines, containerization, and deployment automation
- Monitoring, logging, and observability tools
Nice To Haves
- Experience in healthcare, fintech, or other regulated industries
- Knowledge of healthcare data standards such as HL7, FHIR, and HIPAA compliance
- Experience with high-scale real time data processing
- Familiarity with AI and ML system integration and model serving
- Event-driven architectures, message queues, and async processing
- Exposure to healthcare workflows, EHR systems, or telehealth platforms
- Seed or Series A startup experience
- Advanced degree in CS, engineering, or related field
Responsibilities
- Design and maintain high performance APIs using Python and cloud services to handle millions of requests each month
- Develop RESTful APIs that support AI healthcare tools and internal platform workflows
- Process sensitive patient data in real time while maintaining strict HIPAA compliance
- Coordinate internal APIs to support web platforms and AI decision making
- Implement secure health record exchange with EHR systems, national health networks, and QHINs
- Integrate with telehealth providers, analytics platforms, and third-party healthcare APIs
- Process large volumes of sensitive data with encryption and compliance safeguards
- Build partner API integrations across multiple diverse healthcare systems
- Optimize databases for high-volume, complex healthcare queries
- Implement secure caching and session management using Redis
- Develop error handling, failover, and disaster recovery systems for mission critical services
- Enhance performance and reliability to support rapid user growth
- Coordinate backend workflows for AI tools and clinical decision making
- Develop Python-based deterministic systems alongside AI agents to ensure clinical accuracy
- Build APIs supporting model inference, data preprocessing, and result handling
- Implement validation layers and human escalation protocols for AI safety
- Work on healthcare compliance automation, advanced system monitoring, multi-region deployment, and foundational backend infrastructure for future AI healthcare capabilities.
Benefits
- Competitive compensation and meaningful equity
- Opportunity to build infrastructure impacting millions of patients globally
- Direct collaboration with company leadership and healthcare experts
- Access to modern backend and AI technologies
- Benefits reimbursement
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What This Job Offers
Job Type
Full-time
Career Level
Senior
Education Level
Associate degree
