Senior Backend Engineer

Neonhealth; San Francisco (CA); On-site; USD 180,000 - 240,000; Full time

Job summary

Neon is hiring a senior software engineer to join our fast‑growing team building an AI‑powered healthcare automation platform.

You will own end‑to‑end delivery, shape system design, and engineer across distributed services. The role requires 4–7 years of experience and leads projects with a strong bias for speed and quality.

Qualifications

• Proficiency with Node, Typescript and Python.
• Solid understanding of distributed systems and design tradeoffs.
• Experience in API design, implementation and documentation.
• Familiarity with AI coding tools and modern DevOps practices.
• Strong documentation and testing habits; Git proficiency.

Responsibilities

• Lead project teams, define milestones, and provide updates to stakeholders.
• Prioritize work, propose practical solutions, and drive implementation.
• Collaborate across teams to deliver features across a large codebase.
• Maintain high standards for performance, reliability, and quality.

Skills

Node

Typescript

Python

Distributed systems

API design

AI tooling

Documentation

10x mindset

Time management

Fun

Tools

CI/CD

DevOps

Git

Job description

Join the team making life-saving drugs accessible

The crisis: Sarah delayed cancer treatment for weeks facing $30,000 monthly costs. Marcus's autoimmune condition worsened while battling insurance denials.

Over 50% of critical prescriptions are abandoned due to:

• Cost barriers: Patients with high copays are 5x more likely to abandon treatment

• Insurance maze: Complex prior authorizations block access

• Logistical challenges: Coordinating medical visits for treatments

Our solution: Neon's technology eliminates these obstacles by automating patient access workflows for pharma companies: —automating authorizations, streamlining benefits verification, and unlocking financial assistance.

Join our mission: We want to live in a world where every patient can navigate the healthcare system with ease, especially when it matters most. Help us ensure that access to medicine is determined by clinical need—not bureaucracy or financial constraint. When Neon succeeds, patients access life‑saving treatments without bankrupting their families, while we build an AI automation powerhouse serving healthcare's biggest enterprises.

Why join Neon?

• Frighteningly ambitious: We’re not just idealists. We’re seasoned builders. On a mission to build a $200B+ company—on the scale of Palantir or ServiceNow—serving the largest healthcare enterprises.

• Experienced founding team: Built by exited founders, YC & MIT alum, ex‑Tesla, ex‑Google engineers.

• Hypergrowth with stability: We went from initial idea to 7+ figure customer contracts in just 4 months—in an industry where sales cycles typically take 12‑18 months. We are profitable and relentlessly focused on execution.

• Powerhouse backing: We’re funded by elite Silicon Valley VCs who've backed unicorns like DoorDash, Lyft, and Mammoth Biosciences. And strategic healthcare investors with deep industry connections.

• Outsized impact & opportunity: Work at the intersection of agentic AI, healthcare transformation, and life‑changing patient outcomes.

• Career acceleration: Join early and grow rapidly with us as we scale toward category dominance in healthcare automation.

What’s unique about working here?

Mission‑driven capitalists

We’re a rare blend of mission‑driven capitalists. We are on the path towards building a $200B+ business while dramatically improving the healthcare system—and patients’ lives.

Working like athletes

Like athletes, we are constantly honing our craft to produce our best possible work.

We work with intention and humility. We support and challenge each other to be our best selves.

And as a team, we achieve goals together that would be impossible alone.

Skills Required

Technical skills:

• Proficiency with Node, Typescript, and Python.

• Good understanding of system design concepts - distributed systems, reliability/performance tradeoffs

• Experience in API design, implementation, and documentation

• Experience using AI coding tools (Cursor, Github Copilot, Claude, etc)

• Experience working with CI/CD systems and good DevOps skills a nice to have

• Excellent documentation and testing habits

• Proficiency with version control (Git)

Soft skills:

• 10x mindset - you’ll be among the first engineering hires!

• You are a fun human!

• Good time management and planning skills

Experience

4-7 years of experience (or equivalent) as a software engineer.

We’re leveling this role to Pave’s “P4” level:

Leads project teams, provides direction, and keeps stakeholders informed. Determines key milestones and provides updates and check‑ins to relevant teams and partners.

• You are able to work with the rest of the team to:

  • Define priorities

  • Suggest good solutions

  • Excel at implementation

• You pick up concepts quickly, pattern match on past problems.

• You are obsessed with speed and quality, and help embed that quality into the rest of the team.

• You are self‑directed, and do not need help organizing / prioritizing your time.

Specific project experience

• Nice if you have worked on distributed architectures in the past, but not a strict requirement.

• You must have experience working on projects touching many parts of a large codebase.

Personas - Who should apply?

• Project lead at a scaling startup: You’ve worked at a scaling startup, leading projects that required you to: define requirements, effectively self‑direct and set priorities, and touch many areas of a large code base.

• Generalist: You don’t need to be an expert in any one area of software engineering, but you do need to have experience across many areas of eng. You must know enough to be dangerous in many areas. e.g.) self‑deployed K8s clusters, micro‑services, etc.

• Self‑directed: You’ve led engineering projects from start to finish. This could be a large open source project, or building a feature in a past role.

• Ambitious & effective: We are a team of ambitious builders who are out to win against our competitors. We want to make a big dent in the universe. And to do that, we need to sprint to capture the market before us.

• Ownership mentality: You want to feel a sense of ownership for your work. And you want to have a meaningful chunk of equity — because you know that you can make an outsized contribution towards increasing the value of that equity.

Join Us!

Neon is building the automation platform for healthcare enterprises.

We're backed by top Silicon Valley investors.

We're profitable and growing fast with 7+ figure customer contracts.

Please note: Applicants must be currently authorized to work in the United States on a full‑time basis. Visa sponsorship is not available for this position.