Staff Software Engineer - Backend/Infra [NYC or SF]

About the role

This is a Staff Software Engineer (Backend and Infrastructure) opportunity with a New York clinical AI company that builds infrastructure which health systems, life sciences companies, payors and government agencies use to run patient-facing care. The role builds and owns the core backend services behind the company’s agent platform, which handles millions of conversations each month. You’ll build high-throughput services for concurrent conversations, own a core platform service from design through production, and work on availability and graceful degradation. You’ll handle sensitive healthcare data, improve performance and observability, and make architecture decisions. The posting mentions queues and databases but does not name a specific stack. The ideal candidate will have built and operated production backend systems at scale, with strength in concurrency, distributed systems and service design, a preference for simple, maintainable solutions and the ability to debug across services, queues and databases. Experience in regulated or high-reliability domains, high-throughput or low-latency design and production AI or ML would be advantageous. Years of experience are not stated. This is an on-site role in New York City, with San Francisco as a secondary location. We're looking for someone curious, pragmatic, and eager to work across the stack with a small senior team. You'll own end-to-end delivery of major features, influence architecture, and mentor engineers.

What you'll do

• Ship customer-facing features on a weekly cadence.
• Partner with design and product on scoping and trade-offs.
• Drive technical quality through review, testing, and docs.
• Mentor one or two engineers on your team.

Requirements