Senior Backend Engineer (Community)

Location: Hybrid, with 2–3 days per week in the San Francisco, CA office

Salary: $160,000–$210,000 per year, plus meaningful equity.

Company

A healthcare technology company connects older adults and families with trained companions to provide social support and improve health outcomes.

What you will do

• Build and scale the proprietary virtual-care platform used by care teams.
• Develop and improve revenue cycle management integrations, including claims pipelines, denial handling, and patient responsibility workflows.
• Build member-facing and internal systems such as transactional email and customer support tooling.
• Create data infrastructure, dashboards, automation, patient outreach triggers, and clinical decision-support capabilities.
• Contribute to system design, technology choices, build-versus-buy decisions, and the technical roadmap.
• Own reliability, performance, testing, deployment, monitoring, and documentation for healthcare-critical systems.

Requirements

• 6+ years of software development experience.
• Strong proficiency in Ruby on Rails or Python.
• At least 1 year of hands-on Elixir experience.
• Experience designing and shipping reliable backend systems with appropriate testing, monitoring, rollouts, and code reviews.
• Strong understanding of distributed systems, API design, scalable architecture, and independent feature ownership.
• Ability to work with ambiguity, collaborate with clinical and operational stakeholders, and balance delivery speed with technical quality.

Nice to have

• Experience as an early engineer at a startup or in an environment without an established engineering organization.
• Advanced Elixir expertise, including Phoenix LiveView.
• Healthcare technology experience with FHIR, HL7, X12, EHR integrations, HIPAA-compliant systems, or healthcare APIs.

Culture & Benefits

• High-autonomy, people-first, transparent, and non-hierarchical working environment.
• Access to established deployment pipelines, security compliance, and DevOps support while working with startup-level velocity.
• Medical, dental, and vision insurance.
• HSA, FSA, 401(k) with up to 4% company matching, flexible PTO, and 11 paid company holidays.
• Parental leave, caregiver leave, and meaningful equity package.