Founding Engineer, Backend & Infrastructure

true-talent-solutions-partners; San Francisco (CA); On-site; USD 160,000 - 200,000; Full time

Job summary

true-talent-solutions-partners is seeking a founding backend engineer for an early-stage healthcare AI team in San Francisco. You will own the distributed systems behind clinical and financial workflows, shaping production-grade infrastructure and reliable data processing.

You will collaborate with researchers and product engineers to productionize clinical intelligence, design scalable systems for charts, claims, and payer integrations, and drive end-to-end backend architecture in a fast-paced

Qualifications

• 3+ years of backend software engineering experience focused on infrastructure and complex systems.
• Strong experience with Python, microservices, distributed systems, and end-to-end backend system design.
• Experience in fast-paced startup environments and authorization to work in the United States.

Responsibilities

• Build and scale backend systems for chart processing, claims, authorizations, denials, and payer/provider integrations.
• Own browser and computer-use automation for navigating medical record software and payer portals.
• Design infrastructure for high-volume scanned charts, PDFs, structured claims, unstructured notes, and operational data.
• Build orchestration, queuing, retry, and observability systems for long-running workflows across healthcare platforms.
• Partner with research and product engineers to productionize clinical intelligence capabilities and establish engineering patterns.

Skills

Python

Microservices

Distributed systems

Backend system design

Education

Bachelor’s or Master’s in CS/Math/related field

Job description

ABOUT THE ROLE

Join an early-stage healthcare AI team as its founding backend engineer, owning the distributed systems behind clinical and financial workflows. Your work will help bring clinical intelligence into production and support reliable processing of complex healthcare data.

WHAT YOU'LL DO

• Build and scale backend systems for chart processing, claims, authorizations, denials, and payer and provider integrations.
• Own browser and computer-use automation for navigating medical record software and payer portals.
• Design infrastructure for high-volume scanned charts, PDFs, structured claims, unstructured notes, and operational data.
• Build orchestration, queuing, retry, and observability systems for long-running workflows across healthcare platforms.
• Partner with research and product engineers to productionize clinical intelligence capabilities and establish engineering patterns.

WHAT WE'RE LOOKING FOR

• At least 3 years of backend software engineering experience focused on infrastructure and complex systems.
• Strong experience with Python, microservices, distributed systems, and end-to-end backend system design.
• Experience scaling backend infrastructure at a technically complex company, such as in data infrastructure or fintech.
• Experience with LLMs or machine learning models in production, and ideally with data pipelines, workflow orchestration, large messy datasets, or complex integrations.
• A bachelor's or master's degree in computer science, math, or a related field, or equivalent strong technical foundations.
• Experience in fast-paced startup environments, interest in early-stage work and team leadership, and authorization to work in the United States.

COMPENSATION & BENEFITS

Base salary: $160,000 to $200,000 annually. Visa sponsorship is not available.

LOCATION

On-site in San Francisco, United States.