Senior Backend Engineer, AI System Integration

Backend Engineer (AI Healthcare Platform)Location: New York City | Employment: Full-Time | Dept.: EngineeringCompensation: Competitive base significant equity (seed-stage)OverviewSeeking a skilled Backend Engineer to build and scale the infrastructure behind an AI healthcare platform serving millions of patients. This role sits at the intersection of high-scale backend engineering and AI systems—owning secure APIs, distributed services, and data pipelines that power 14M patient interactions with uncompromising reliability and healthcare compliance.What You'll BuildHealthcare API InfrastructureHigh-throughput Python/FastAPI services on AWS to handle millions of daily requestsRESTful APIs for a growing suite of AI healthcare tools and internal coordination systemsReal-time processing of sensitive PHI with HIPAA-compliant controlsInternal API architecture supporting web clients and AI orchestrationIntegration & Data SystemsSecure health record exchange with EHRs, QHINs, and major healthcare networksThird-party integrations (telehealth, analytics, healthcare APIs)Large-scale, encrypted data pipelines with compliance guardrailsPartner API integrations across diverse, well-documented healthcare systemsScale & Reliability ArchitectureDatabase design and optimization (complex query patterns on high-volume healthcare data)Redis for secure caching/session management in regulated environmentsRobust error handling, automated failover, and disaster recoveryPerformance tuning and horizontal scaling for rapid user growthAI System IntegrationBackend coordination that guides AI tools and clinical decision workflowsDeterministic Python systems running alongside AI agents for clinical accuracyAPIs for model inference, preprocessing, and result handlingInfrastructure for AI safety (validation layers, human-in-the-loop escalation)You'll also contribute to compliance automation, advanced monitoring/observability, multi-region deployments, and the backend foundation for next-gen AI healthcare features.Required QualificationsEducation & BackgroundCS degree or exceptional equivalent experience (Engineering/Math welcome)Startup DNA: founder/founding engineer or deep early-stage experience preferredProven independence solving complex problems and strong cross-functional collaborationTechnical Expertise5 years backend engineering with Python and API developmentStrong with FastAPI/Flask (or similar) and cloud services (AWS/GCP/Azure)Built/scaled RESTful APIs for high-volume trafficProficient with relational DBs (PostgreSQL/MySQL) and performance tuningKnowledge of Redis, caching strategies, and distributed systems designSystem Design & IntegrationThird-party API integrations, webhooks, and microservices patternsSecurity best practices for sensitive data and API designCI/CD, containers (Docker), and deployment automationMonitoring/logging/observability (metrics, tracing, alerts)Preferred QualificationsExperience in healthcare, fintech, or other regulated domainsFamiliar with HL7, FHIR, and HIPAA requirementsHigh-scale data processing and real-time systemsBackground with AI/ML systems and model servingMessage queues, event-driven, and async architecturesKnowledge of healthcare workflows, EHRs, or telehealth platformsSeed/Series A startup experienceAdvanced degree in CS/Engineering (or related)What We OfferCompetitive salary meaningful equity (seed-stage, top-tier investors)Direct impact on healthcare access for millions of patientsHigh autonomy, technical leadership, and direct line to the CEOAccess to cutting-edge tech and resources to solve complex scaling challengesCollaboration with leading AI engineers and healthcare technologistsBenefits reimbursement