Senior Backend Engineer – Healthcare Interoperability

Axle Health; Santa Monica; On-site; PHP 9,231,000 - 12,923,000; Full time

Job description

About Us

Axle Health builds AI scheduling and workforce management software to empower in-home healthcare providers to deliver exceptional, personalized care right where patients feel most comfortable—at home.

Some of the biggest providers in the country use our software (like Cityblock Health and U Penn Health System) to improve the utilization of their field teams by 17%+, and automate the operational burden of scheduling and dispatching.

Our platform includes proprietary logistics algorithms to optimize scheduling, a mobile app for field staff, an operations dashboard for office teams, engagement and booking tools for patients, and a wide range of integrations and external APIs for modular access.

We’re a team of top-tier engineers and operators, backed by $14m from top investors such as Y Combinator, Pear VC, and F-Prime, applying our intellect and logistics experience to upend how home healthcare is delivered.

About You, the Role

We're looking for a Senior Software Engineer to join our Healthcare Interoperability team; the group responsible for connecting Axle Health's scheduling and workforce management platform directly into the daily workflows of home healthcare providers. This is a high-leverage, high-ownership role: you'll design and build the integrations that make Axle Health indispensable to our customers, and you'll help shape how our team works as we scale.

Our ideal candidate brings deep backend expertise, strong architectural instincts, and a genuine passion for solving complex problems in systems that matter. You've built reliable, high-volume systems before, whether at scale at a growth stage company or from the ground up at a startup, and you know how to lead technical work across a team without losing your connection to the code. If you're energized by meaningful technical challenges and want your work to directly improve care delivery for patients, we want to hear from you.

What you'll do:

• Design and implement Electronic Health Record (EHR) or Electronic Medical Record (EMR) integrations that connect Axle Health's platform into providers' existing tech stacks

• Architect high-volume backend systems built to support hundreds of thousands of patients reliably and at scale

• Develop and evolve API integrations across the Axle Health ecosystem, with a focus on performance, security, and maintainability

• Lead technical design discussions and drive engineering decisions from initial scoping through delivery

• Collaborate with and provide technical leadership to other engineers, setting a high bar for code quality through thorough and constructive code reviews

• Mentor junior and mid-level engineers, investing in their growth and helping them develop strong engineering fundamentals

• Write clear, thorough documentation to scale team knowledge within the Interoperability team and across engineering

Required skills and experience:

• Bachelor's degree

• 7+ years of professional software engineering experience

• Expertise building backend systems in Node.js + TypeScript (1-2+ years)

• Hands-on experience designing and working with SQL databases (PostgreSQL preferred)

• Demonstrated ability to architect scalable, performant, and secure systems - not just implement within them

• Strong technical communication skills (able to explain complex decisions clearly to both technical and non-technical stakeholders)

• Proven ability to conduct rigorous, constructive code reviews that improve both code quality and team capability

• Experience working in fast paced, high-growth startup environments with a desire to build and a track record of operating with significant autonomy

• Demonstrated ability to self-learn and quickly adapt to new technologies

Nice to have:

• Experience working with Electronic Health Records (EHRs) and/or healthcare interoperability standards (FHIR, HL7)

• Background in a domain where data integrity and security are non-negotiable (healthcare, fintech, etc.)

• Experience working on systems with significant data volume or uptime requirements

• Working knowledge of CI/CD, DevOps practices, and build systems

• Familiarity with the Axle Health tech stack: ExpressJS, GraphQL, React, React Native, PostgreSQL, AWS, Datadog

Tools You May Use

• ExpressJS + TypeScript

• GraphQL + React + React Native

• PostgresSQL

• AWS

• Datadog

• Git / Github / Graphite

• Django + Python3

• Claude Code and Cursor

What We Offer

In addition to offering a competitive salary and equity, we want to ensure every team member has the tools they need to work to the best of their ability. To that end…

We are committed to your Ownership:

• We cultivate an environment where team members feel ownership over the work they do. Everyone in an organization has big ideas and we want to hear them and implement them.

• All of our employees have equity compensation. We want you to benefit from all the hard work you do in helping patients and catalyzing this shift in healthcare.

We are committed to your Wellness:

• Medical, Dental, Vision

• 401k plan

• Flexible PTO and sick days

• Commuter benefits

• Santa Monica HQ with 180 degree beach views and daily catered lunches

We are committed to your Growth:

• Fast paced work environment geared towards professional growth

• Get the chance to move roles within the organization to learn new skills and continue to make an impact

We are committed to building Community:

• Monthly team events, dinners, & happy hours

• Special team outings - some past events have included: yacht cruises, visits to Universal Studios, Magic Castle, and Vegas