Demo

Senior Engineer (Backend + Data)

Trial Library
San Francisco, CA Full Time
POSTED ON 1/14/2026
AVAILABLE BEFORE 3/13/2026

Our mission is to improve health equity by expanding access to cancer precision medicine.


About Trial Library

Trial Library, Inc. is a venture-backed startup founded in 2022 focused on accelerating enrollment and retention to clinical trials with an AI-platform. Trial Library is a mission-driven health technology company dedicated to improving health equity in cancer care by expanding access to precision medicine through clinical trials. We work with community oncology sites, patients, and industry partners to ensure that clinical research is accessible, navigable, and inclusive.


We are seeking a hands-on Senior Engineer to build new critical systems and scale our clinical trial recruitment platform. You'll take ownership of major initiatives as we expand into new markets and service offerings. This could include building an external-facing reporting and analytics platform, standing up production-grade APIs for partner interconnectivity, or scaling our data infrastructure.


Our engineering team embodies our company culture: high trust and low politics, where fast decision-making and open feedback are the norm. We foster a psychologically safe, collaborative environment where engineers are empowered to take action, speak up, and solve problems efficiently.

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Your Responsibilities
  • Design and build scalable backend systems: Own the architecture and implementation of core backend services, APIs, data systems, and infrastructure
  • Drive technical decisions: Make pragmatic architectural choices, evaluate tradeoffs, and set technical direction for your areas of ownership
  • Ship production code daily: Write code, review PRs, debug issues, and deliver features hands-on as a working engineer
  • Advocate for quality: Push back on unrealistic timelines, champion technical excellence, and ensure we're building sustainably
  • Collaborate cross-functionally: Partner with engineering leadership, product, frontend engineers, AI engineers, and SDET to deliver end-to-end solutions
  • Ensure compliance and security: Maintain healthcare compliance standards (HIPAA) and implement security best practices across systems
  • Elevate engineering practices: Establish testing strategies, development workflows, and technical standards as the team scales


Qualifications
  • Strong Python and SQL skills: our stack is Python (AWS Lambda) Postgres, and you'll be writing both daily
  • Startup experience: you've built things from scratch at an early-stage company and embraced the fast-paced, dynamic environment
  • Small team comfort: excited to wear many hats, jump into different areas as needed, and thrive without rigid role boundaries
  • High autonomy:  as the second backend engineer, you'll work directly with a Staff Engineer and have real influence on technical direction. You figure things out independently, make decisions with incomplete information, and own outcomes
  • Hands-on mentality: you're an engineer first who writes code daily, not an architect who only reviews
  • 0-1 building experience: you've taken something from idea to production and know what it takes
  • Systems thinking: strong understanding of backend architecture, APIs, databases, and scalability
  • Communication skills: can push back respectfully, explain technical tradeoffs, and work cross-functionally
  • Healthcare alignment: genuinely interested in improving clinical trial access and health equity


Nice to Have
  • Data and analytics platform experience: building data warehouses, ETL pipelines, analytics infrastructure, and external-facing reporting/analytics platforms
  • Cloud infrastructure experience: we use AWS, but experience with any major cloud provider is valuable
  • API design experience: RESTful APIs, API documentation, versioning strategies
  • AI-augmented development: experience leveraging AI coding tools (Claude Code, Cursor, GitHub Copilot, etc.) to boost productivity
  • Healthcare/regulated industry background: HIPAA, clinical data, healthcare tech
  • DevOps/Infrastructure: CI/CD, monitoring, logging, infrastructure as code


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Our Core Values


1. Ally is our favorite moniker

2. The most inclusive approach is worth the work

3. Celebrate measurable improvements in equity outcomes

4. Fearless advocates for belonging

5. Incentives matter to stakeholders choosing our products

6. Taking initiative is actually giving 

7. We are accountable for the experience of patients and providers

8. Empathy and humility are the real dynamic duo


Trial Library, Inc. provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to age, ancestry, color, family or medical care leave, gender identity or expression, genetic information, marital status, medical condition, national origin, physical or mental disability, political affiliation, protected veteran status, race, religion, sex (including pregnancy), sexual orientation, or any other characteristic protected by applicable laws, regulations, and ordinances.


Salary.com Estimation for Senior Engineer (Backend + Data) in San Francisco, CA
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