Back End Developer

Nxt Level; San Francisco (CA); On-site; USD 190,000 - 270,000; Full time

Benefits offered by this job

Competitive compensation

Meaningful equity

Direct collaboration with leadership

Access to modern backend and AI tech

Job summary

Nxt Level is building AI technology to make healthcare accessible and free for everyone. We seek backend engineers to design scalable infrastructure supporting billions of AI-driven consultations while ensuring medical safety and HIPAA compliance.

You will design high-performance APIs in Python, implement secure data processing, and integrate with healthcare systems across regions. Join a fast-moving team shipping end-to-end from concept to production.

Qualifications

• BS in CS or equivalent hands-on experience.
• Strong Python knowledge with FastAPI/Flask.
• 6+ years backend engineering experience.
• Cloud services experience and high-volume API handling.
• Redis, caching strategies and distributed systems design.

Responsibilities

• Design and maintain high performance APIs using Python and cloud services.
• Develop RESTful APIs for AI healthcare tools and internal workflows.
• Process sensitive patient data with HIPAA compliance.
• Coordinate internal APIs to support web platforms and AI decisions.
• Implement secure caching and session management with Redis.
• Build partner API integrations across healthcare systems.

Skills

Python

FastAPI/Flask

Cloud services

Relational databases

Redis / caching

Distributed systems

Education

B.S. in Computer Science

Engineering or math degree welcomed

Tools

Docker

CI/CD pipelines

Kubernetes

Job description

Our client is building AI technology to make healthcare accessible and free for everyone. They are seeking backend engineers to develop scalable infrastructure that supports billions of AI driven consultations while ensuring medical safety and HIPAA compliance.

This role is central to delivering reliable and secure systems at massive scale.

WHAT YOU WILL BUILD

• Design and maintain high performance APIs using Python and cloud services to handle millions of requests each month
• Develop RESTful APIs that support AI healthcare tools and internal platform workflows
• Process sensitive patient data in real time while maintaining strict HIPAA compliance
• Coordinate internal APIs to support web platforms and AI decision making

Integration and Data Systems

• Implement secure health record exchange with EHR systems, national health networks, and QHINs
• Integrate with telehealth providers, analytics platforms, and third-party healthcare APIs
• Process large volumes of sensitive data with encryption and compliance safeguards
• Build partner API integrations across multiple diverse healthcare systems

Scale and Reliability

• Implement secure caching and session management using Redis
• Develop error handling, failover, and disaster recovery systems for mission critical services
• Enhance performance and reliability to support rapid user growth

AI System Integration

• Coordinate backend workflows for AI tools and clinical decision making
• Develop Python-based deterministic systems alongside AI agents to ensure clinical accuracy
• Build APIs supporting model inference, data preprocessing, and result handling
• Implement validation layers and human escalation protocols for AI safety

This role also includes work on healthcare compliance automation, advanced system monitoring, multi-region deployment, and foundational backend infrastructure for future AI healthcare capabilities.

HOW THE CLIENT OPERATES

• Engineering led environment with minimal process overhead
• Flat structure with direct collaboration with company leadership
• End to end ownership from concept to production
• Fast moving team with strong judgment and accountability

WHAT THE CLIENT IS LOOKING FOR

Background

• Computer science degree or equivalent hands on experience
• Engineering, math, or related technical degrees welcomed
• Track record of operating at a high engineering standard
• Founder level ownership mindset or early stage startup experience preferred
• Ability to work independently while collaborating across teams

Technical Experience

• Six or more years of backend engineering experience
• Strong experience with Python and frameworks such as FastAPI or Flask
• Cloud services experience and high volume API handling
• Proficiency with relational databases and performance optimization
• Experience with Redis, caching strategies, and distributed systems design

System Design and Integration

• Third-party API integration and webhook management
• Microservices architecture and distributed system patterns
• Security best practices for sensitive data and API design
• CI/CD pipelines, containerization, and deployment automation
• Monitoring, logging, and observability tools

NICE TO HAVE

• Experience in healthcare, fintech, or other regulated industries
• Knowledge of healthcare data standards such as HL7, FHIR, and HIPAA compliance
• Experience with high-scale real time data processing
• Familiarity with AI and ML system integration and model serving
• Event-driven architectures, message queues, and async processing
• Exposure to healthcare workflows, EHR systems, or telehealth platforms
• Seed or Series A startup experience
• Advanced degree in CS, engineering, or related field

WHAT THE CLIENT OFFERS

• Competitive compensation and meaningful equity
• Opportunity to build infrastructure impacting millions of patients globally
• Direct collaboration with company leadership and healthcare experts
• Access to modern backend and AI technologies