Backend Engineer

San Francisco, CA · On-site · Full-time

Compensation: $120,000–$250,000 + equity (0%–2%)

About the Company

An early-stage, venture-backed healthcare AI company building the agentic intelligence layer for healthcare. Its AI agents read, reason over, and adjudicate complex clinical cases in real time, automating administrative clinical work and pushing decisions directly into payer systems - already processing tens of thousands of requests per month. The company reached $1M+ in revenue within four months of commercialization and has grown ARR roughly 10x over the past six months.

Founded 2024 · 11–50 people · Industry: Healthcare

The Role

Own and scale the backend and AI infrastructure behind an agentic clinical-decision platform, supporting rapid customer onboarding and growth in a production healthcare environment. You'll architect AI-native systems, drive product iterations end-to-end, and own critical backend infrastructure, with the opportunity to build and manage your own engineering team as the company scales.

What you'll be doing

Architect and deploy AI-native systems to support large data volumes via API

Shape the next product iterations end-to-end, integrating first-hand customer feedback

Build reliable and secure agentic infrastructure for processing clinical information of millions of patients

Work with an experienced team of ex-founders, operators, and clinicians

Tech stack: Python-centric backend; infrastructure-as-code (Terraform or similar); LLM and agentic tooling.

Requirements

Proficient in Python (hard requirement)

Infrastructure as code experience (Terraform or similar - hard requirement)

Understanding of prompt engineering

Strong GitHub contribution profile with active commits

Currently employed in a role at an established company (not unemployed, not running own consultancy)

Must be available to work in-person 5 days per week in San Francisco

Green Flags

Competitive background in any domain (sports, esports, chess, coding competitions, Kaggle, etc.) - shows extraordinary ability

Prior founding experience or startup experience

Founding team member experience

High agency and strong decision-making track record

Experience with browser automation

Active open source contributions

Mix of IC skills with people management potential

Red Flags

Not currently employed

Running own consulting company rather than working at established company

Short tenures/frequent job hopping

Arrogant attitude

Dishonesty or lying (especially about using AI tools like Claude during interviews)

Only doing code reviews rather than hands-on coding

Lack of personal projects or side work

Why Join

Real, fast traction with engineering as the primary growth constraint - high-leverage, high-ownership work

Architect AI-native systems end-to-end and own critical backend infrastructure from day one

Clear path into technical leadership as the team scales

Strong resources: significant GPU access, latest Mac, and AI coding/chat assistants

Full benefits: stock options, health/dental/vision, unlimited PTO, and visa sponsorship (H-1B, O-1)

Details

Location - San Francisco, CA

Work policy - In-person, 5 days/week

Compensation - $120,000–$250,000 + equity

Visa sponsorship - H-1B, O-1, OPT

Employment type - Full-time

Experience - 1+ years