Fullstack Engineer

Ersilia; Medellín; Remote; COP 90,000,000 - 180,000,000; Full time

Job summary

Ersilia is seeking a senior backend/Integration Engineer to design, build, and own complex healthcare integration systems that connect our platform to medical infrastructure. Expect ownership from design to production, with emphasis on reliability and production-readiness.

The role requires 5+ years of backend experience with Node.js and Python, and hands-on work with PostgreSQL and MongoDB. Remote-first, Latin America-based, with strong collaboration across teams.

Qualifications

• 5+ years of backend engineering experience with production systems.
• Hands-on experience building and operating backend systems in production environments.
• Strong backend fundamentals including queues, async patterns, error handling and observability.
• Experience with PostgreSQL and MongoDB.
• Comfortable with ambiguity and taking ownership of production systems.
• Proficient in Node.js and Python.
• Direct and clear communication.
• Spanish - native or fluent.

Responsibilities

• Integration system design and ownership.
• Design, build, and own complex integration systems where reliability impacts clinical workflows.
• First-principles system mapping of undocumented components.
• High-agency execution and proactive decision logging.
• Production ownership including runbooks and incident follow-up.
• Mentorship through code reviews and knowledge sharing.
• Open source engagement and thoughtful use of community software.

Skills

Node.js

TypeScript

Python

REST API design

GraphQL API design

Tools

PostgreSQL

MongoDB

Job description

Client Information

Our client build real-time AI products for healthcare — medical transcription, clinical record generation, and EHR integrations across Brazil and Colombia. The integrations layer is the nervous system connecting hospitals, clinics, and electronic health record systems to the platform. The work is technically demanding and the stakes are real: reliability here directly impacts clinical workflows.

Full stack Engineer

Design, build, and own complex integration systems for healthcare AI products, impacting clinical workflows. Requires 5+ years backend engineering experience with Node.js, TypeScript, Python, REST API design, GraphQL API design.

ABOUT THE ROLE

We're looking for an Integration Engineer to design, build, and own the complex integration systems that connect our platform to healthcare infrastructure. This is not an execution role — you'll shape how the team thinks and builds, work from first principles on undocumented systems, and take genuine ownership of production.

You'll move with high agency, document decisions, mentor through code reviews, and engage seriously with open source. The expectation is that you stand behind your work — from design through to incident response.

WHAT YOU'LL WORK ON

Integration system design and ownership

Design, build, and own complex integration systems where reliability directly impacts clinical workflows. You're not just building features — you're building infrastructure other systems depend on.

First-principles system mapping

Map complex, undocumented systems and build a clear mental model from scratch. You'll regularly encounter systems with no spec — your job is to figure them out.

High-agency execution

Find ways around obstacles, document decisions clearly, and keep the team informed. You don't wait for permission or perfect information — you move and communicate.

Production ownership

Write runbooks, follow up on incidents, and stand behind your work in production. Reliability isn't someone else's problem — it's yours.

Mentorship and code reviews

Actively mentor the team through meaningful code reviews — not just flagging issues, but explaining the reasoning behind decisions so everyone gets better.

Open source engagement

Read source code to debug issues, contribute patches where appropriate, and build thoughtfully on top of open-source software — not just consume it.

WHAT WE LOOK FOR

• 5+ years of backend engineering experience
• Solid hands-on experience building and operating backend systems in production environments — with the depth that comes from owning things, not just shipping them.
• Strong backend fundamentals
• Deep understanding of queues, async patterns, error handling, and observability. You know why these things matter and how to apply them under pressure.
• Experience withPostgreSQL and MongoDB
• Comfortable with both — schema design, query optimisation, and understanding the trade-offs between the two in real-world contexts.
• Comfort with ambiguity
• You don't need a complete spec to start. You figure out what questions to ask, make reasonable assumptions, document them, and move.
• Node.js and Python
• Intellectually curious about both ecosystems — not just able to use them, but interested in how they work and what's happening in the community around them.
• Direct communication
• You say what you think, flag problems early, and communicate clearly with the team — especially when things aren't going to plan.
• Spanish- native/ fluent

THE TEAM

A small, senior engineering team building real-time AI infrastructure for healthcare. The work is technically hard, the domain is consequential, and the team operates with high trust and high standards. Remote-first, based across Latin America.

Briefing Notes

Mission & Context

Our client builds real-time AI products for healthcare in Brazil and Colombia, focusing on transcription and clinical record generation. This role is critical as it involves building and owning the core integration layer, the "nervous system" that connects hospitals, clinics, and EHR systems to the the platform, where reliability is paramount.

Candidate Overview

A senior backend engineer with 5+ years of experience, possessing deep expertise in building complex, reliable integration systems. Must have strong fundamentals in asynchronous patterns, queues, and observability, with hands-on experience in Node.js, TypeScript, Python, PostgreSQL, and MongoDB. The candidate must be comfortable navigating ambiguity and taking ownership of production systems, as their work directly impacts clinical workflows.

Nice-to-Haves

Experience with both REST and GraphQL API design.

Previous work in the healthcare technology sector, especially with EMR/EHR integrations.

Experience in a high-growth startup environment.

Soft Skills

High agency and proactivity; finds ways around obstacles without waiting for direction.

Strong sense of ownership; comfortable writing runbooks and handling production incidents.

Intellectually curious, especially about the Node.js and Python ecosystems.

Direct and clear communicator.

Mentorship-oriented; enjoys elevating the team through code reviews and knowledge sharing.

Green Flags

• Experience building and maintaining integrations in a high-stakes environment (e.g., healthcare, fintech).
• Demonstrated history of mapping complex, undocumented systems from first principles.
• Contributions to open-source projects, particularly within the Node.js or Python ecosystems.
• Proven experience mentoring junior engineers through code reviews and technical guidance.

Red Flags

• Experience exclusively in large, highly structured corporate environments with little ambiguity.
• Lack of hands-on experience with both a dynamically typed language (Python) and a statically typed one (TypeScript).
• Candidates without experience in at least one of the required databases (PostgreSQL or MongoDB).
• Inability to discuss backend fundamentals like async patterns and error handling with depth.
• Candidates not located and authorized to work in Brazil or Colombia.

Soft Skills

High agency and proactivity; finds ways around obstacles without waiting for direction.

Strong sense of ownership; comfortable writing runbooks and handling production incidents.

Intellectually curious, especially about the Node.js and Python ecosystems.

Direct and clear communicator.

Mentorship-oriented; enjoys elevating the team through code reviews and knowledge sharing.

Visa & Work Authorization

This is a remote role for candidates located in the Colombia or Brazil. There is a preference for candidates based in or near São Paulo or Medellín, but it is not a requirement.