Staff Engineer, Backend & Data

Trial Library•San Francisco, CA

7d•$168,000 - $230,000•Hybrid

About The Position

We're hiring a second Staff Engineer to own key parts of our backend and data platform. Our platform supports our teams that identify eligible patients for clinical trials and navigate patients around any barriers to enrolling in a trial. You will take technical leadership of our most critical systems as we navigate a massive architectural shift that will be a step-change in our ability to refer patients to trials: moving from narrow, human-assisted data pulls to robust, automated integrations with EMR systems to ingest complete patient records. If cloud-native architecture, building AI agents to empower our human experts, exploring non-deterministic approaches to patient-trial matching, and handling HIPAA-grade data sounds like the right problem space, please keep reading. Our engineering culture values direct communication, strong ownership, and low-ego collaboration. We laugh a lot and use a ton of Slack emojis. We make decisions quickly, give open feedback, and we have a strong bias toward action. Our use of AI in our products is intended to make our authentic interactions with patients, doctors, and others as meaningful as possible. That means using AI to help with all of the operational aspects of the interactions, from helping decide who to call and when, to assisting with transportation scheduling, to queuing up ranked potentially eligible patients for a human to review and validate. This enables our people to focus 100% on authentic interactions with other people. AI is also deeply embedded in our SDLC. Our embrace of AI didn't come from a mandate but from our own desire as engineers to do more safely. We use it for coding, testing, measuring, and iterating. We've seen what it unlocks and treat it as a genuine competitive advantage. We view effective use of these tools as an important part of engineering leverage and velocity. We are looking for someone who shares that instinct: someone excited to reinvent long-standing processes, question assumptions about where human attention should be focused, and think ambitiously about what is possible when you pair strong engineering fundamentals with AI tooling. If you are already building that way, you will fit right in. Underneath all of this is a modern, evolving platform built for scale and iteration. Our backend is primarily Python and actively moving toward Typescript. Our frontend is a React (Typescript) SPA, and our infrastructure is built on AWS using Lambda, Bedrock, Fargate, SQS, and RDS with Terraform-managed infrastructure. Our data layer is centered around PostgreSQL and Drizzle. We care deeply about pragmatic architecture decisions, developer velocity, and building systems that can evolve quickly as both our product and AI capabilities mature.

Requirements

Significant backend depth, 8 or more years of experience, with 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, where you have built from scratch at an early-stage company and treated ambiguity as an opportunity rather than an obstacle.
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 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: the kind of problems where serial processing breaks under load, timeouts become production incidents, and the right architecture (async pipelines, message queues, container-based compute) is what separates a working feature from a failing one.
Independently monitor production, triage issues quickly, and maintain a close read on how our platform is actually experienced by the clinicians, coordinators, and partners who depend on it.
Exercise pragmatic judgement, matching the technology to the business need.
Make decisions around which AI models to use, and how to operationalize “token economics”.
Shape how good engineering gets done at Trial Library.
Continuously rethink what engineering excellence actually looks like.
Transition the team into a world less bottlenecked by execution, and more by review and verification.
Keep a close pulse on how AI is changing software development, evaluate emerging practices critically, and champion the approaches that make sense for our organization.
Set standards for how code reviews are done, how tests get written, what shared conventions need to exist, and where human judgment is most needed.
Mentor engineers and set development standards that stay relevant as the tools underneath all of us keep evolving.

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
Additional programs that support the diverse needs of our team members and their families.