Senior Back-end / Full-Stack Engineer

Ekkomd; Chennai, Tiruchirappalli, Coimbatore District, Bengaluru, Hyderabad; On-site; INR 2,800,000 - 5,200,000; Full time

Job summary

Ekko Medical Solutions Private Limited is seeking a Senior Back-end / Full-Stack Engineer to own Ekko's backend architecture from the ground up. You’ll build real-time audio ingestion, LLM orchestration, and clinical data pipelines powering our web app, backend service, and browser extension.

You will work directly with the CTO and collaborate with frontend and product teams to ship reliable, scalable infrastructure.

Qualifications

• 5+ years production backend development; 2+ years in senior or lead capacity.
• Strong Node.js and TypeScript proficiency, ideally with NestJS.
• SQL expertise with ORM experience (Prisma preferred).
• Real-time systems experience (WebSockets, streaming, event-driven architecture).
• Third-party API integration at scale, particularly AI/LLM services.
• AWS cloud infrastructure knowledge
• Redis caching layer experience
• Full-stack React/TypeScript capability
• Startup environment comfort and flexibility

Responsibilities

• Build and scale NestJS/TypeScript backend services.
• Design and maintain data models using Prisma ORM.
• Implement real-time audio streaming and event flows over WebSockets (socket.io).
• Manage caching, queues, and performance with Redis.
• Design REST and WebSocket APIs for the web application.
• Implement authentication and access controls for sensitive clinical data (Auth0/JWT).
• Document APIs using Swagger.
• Establish testing standards (Jest), error handling, and observability.
• Manage AWS infrastructure (S3, SES, Lambda, CloudFront).
• Contribute React/TypeScript frontend work as needed.

Skills

NestJS/TypeScript

Node.js

React/TypeScript

WebSockets

Redis

AWS

Tools

Prisma ORM

Swagger

JWT/Auth0

GitHub Actions

Job description

Ekko is an AI-powered healthcare product that turns clinical conversations into structured documentation. Our pipeline transcribes audio, generates clinical notes, and extracts structured data using LLMs. We ship across three surfaces — a web app, a backend service, and a browser extension — used by clinicians who depend on accuracy. We're a small, early-stage team.

We're hiring a Senior Back-end / Full-Stack Engineer to own Ekko's backend architecture from the ground up. You'll build the services that power real-time audio ingestion, LLM orchestration, and clinical data pipelines — systems that clinicians depend on in live patient encounters. You'll work directly with the CTO and collaborate closely with the frontend and product teams to ship reliable, scalable infrastructure.

Core Backend Development

• Build and scale NestJS/TypeScript backend services
• Design and maintain data models using Prisma ORM
• Implement real-time audio streaming and event flows over WebSockets (socket.io)
• Manage caching, queues, and performance with Redis

AI & Audio Pipeline

• Integrate speech-to-text providers: AWS Transcribe, Google Speech, Azure Speech
• Orchestrate LLM workflows for clinical note generation and data extraction
• Design reliability features: retries, fallbacks, graceful degradation

API & Security

• Design REST and WebSocket APIs for the web application
• Implement authentication and access controls for sensitive clinical data (Auth0/JWT)
• Document APIs using Swagger

Operations & Full-Stack Contribution

• Establish testing standards (Jest), error handling, and observability
• Manage AWS infrastructure pragmatically (S3, SES, Lambda, CloudFront)
• Contribute React/TypeScript frontend work as needed

What You Bring

• 5+ years production backend development; 2+ years in senior or lead capacity
• Strong Node.js and TypeScript proficiency, ideally with NestJS
• SQL expertise with ORM experience (Prisma preferred)
• Real-time systems experience (WebSockets, streaming, event-driven architecture)
• Third-party API integration at scale, particularly AI/LLM services
• AWS cloud infrastructure knowledge
• Redis caching layer experience
• Full-stack React/TypeScript capability
• Startup environment comfort and flexibility

Nice to Have

• LLM pipeline production experience
• Healthcare or high-trust software background
• Compliance knowledge (HIPAA, NABH, DPDP)
• Audio/media processing experience
• CI/CD experience (GitHub Actions)

Why join Ekko

• Real ownership. You're not a cog in a 500-person company — you're defining how Ekko's backend runs.
• AI product depth. You'll work on problems most backend engineers never touch — real-time LLM pipelines in a clinical setting.
• Direct impact. Small team, fast feedback, decisions made in days not quarters.
• Good people. We take the work seriously and ourselves a lot less so.