Staff Engineer, Backend & Data

Trial Library•San Francisco, CA

6d•Hybrid

About The Position

Trial Library is seeking a Staff Engineer to own key parts of their backend and data platform. This role involves technical leadership in a significant architectural shift towards automated integrations with EMR systems for ingesting complete patient records, moving away from human-assisted data pulls. The position is ideal for someone interested in cloud-native architecture, AI agents, non-deterministic patient-trial matching, and handling HIPAA-grade data. The engineering culture emphasizes direct communication, strong ownership, and low-ego collaboration, with a bias towards quick decision-making and open feedback.

Requirements

Significant backend depth with 8 or more years of experience.
At least a couple of years operating at staff scope or equivalent impact.
Demonstrated high-impact ownership.
Deep AWS experience (Lambda, Fargate, SQS, RDS, and the surrounding ecosystem) and the ability to choose the right service for the right job.
Proven track record of leveraging AI coding tools creatively and effectively to build production systems.
Demonstrated ability to take autonomous ownership, identifying and resolving systemic issues independently.
Startup experience, having built from scratch at an early-stage company and treated ambiguity as an opportunity.
Strong systems thinking, encompassing backend architecture, APIs, databases, and scalability under real-world constraints.
Clear communication and influence, with the ability to explain tradeoffs to both engineers and non-engineers to earn trust through honesty.
Healthcare alignment with a genuine interest in improving clinical trial access and health equity.
HIPAA experience is a strong plus.

Nice To Haves

Experience with data and analytics platforms, such as data warehouses, ETL pipelines, or external-facing reporting infrastructure.
Familiarity with IaC tooling (Terraform, Pulumi, etc).
Familiarity with clinical or healthcare data standards (EHR/EMR, HL7/FHIR).
Familiarity with API design patterns.
Experience in a regulated industry.

Responsibilities

Own the systems that power Trial Library's core workflows and be accountable for their reliability, evolution, and scale.
Design for reliability in compute-intensive, long-running workflows, utilizing architectures like async pipelines, message queues, and container-based compute.
Independently monitor production, triage issues quickly, and maintain a close understanding of how the platform is experienced by users.
Exercise pragmatic judgment, matching technology to business needs.
Make decisions around which AI models to use and how to operationalize 'token economics'.
Shape how good engineering is done at Trial Library, rethinking engineering excellence in the context of evolving AI tools.
Transition the team to a state less bottlenecked by execution and more by review and verification.
Keep a close pulse on how AI is changing software development, critically evaluate emerging practices, and champion suitable approaches.
Establish best practices for code reviews, test writing, shared conventions, and the optimal placement of human judgment.
Mentor engineers and set development standards that remain relevant as tools evolve.

Benefits

Comprehensive medical, dental, and vision coverage for employees and eligible dependents.
Disability, life, and supplemental insurance options.
Flexible paid time off.
Observed company holidays.
One-time home office stipend.
401(k) program.
Pre-tax HSA and FSA options.
Commuter benefits.
Financial wellness resources.
Access to legal protection plans.
Access to voluntary benefit offerings including pet wellness support, domestic partner coverage, and additional programs.