Senior Backend Engineer

Steer Health; United States; Remote; USD 150,000 - 195,000; Full time

Benefits offered by this job

Equity

Competitive salary

Benefits package

Job summary

Steer Health is hiring a Senior Backend Engineer to design, build, and scale core services behind our AI-powered platform. You will work on real-time data pipelines, EHR integrations, and backend infrastructure that powers our agents.

You will own architecture from design to production, focusing on reliability, observability, and secure, scalable systems in a fast-growing startup environment.

Qualifications

• 5+ years of backend engineering with ownership of production systems.
• Expert-level Node.js and TypeScript in production.
• Hands-on experience designing and operating Kafka-based eventing architectures.
• Deep MongoDB experience at scale, including schema design, indexing, aggregation pipelines, replication, and query optimization.
• Healthcare or health tech background, including EHR integrations, FHIR or HL7, HIPAA, and PHI handling.

Responsibilities

• Design, build, and operate backend services and APIs in Node.js and TypeScript.
• Architect and extend our event-driven systems on Kafka, including topic design, producers and consumers, stream processing, delivery guarantees, and back-pressure at scale.
• Own MongoDB data modeling and performance, including schema design, indexing, aggregation pipelines, replication, and query optimization.
• Build reliable, secure integrations with EHRs, healthcare data standards (FHIR, HL7), and third-party APIs.
• Support AI agent workflows with fast, resilient backend services and real-time data pipelines.
• Drive reliability and observability: monitoring, alerting, load testing, incident response, and postmortems.
• Handle PHI responsibly and uphold HIPAA-grade security practices across every service you touch.
• Raise the engineering bar through design docs, code reviews, and mentoring.

Skills

Node.js

TypeScript

Kafka

MongoDB

EHR integrations

HIPAA

Cloud (AWS)

Docker

Kubernetes

LLM/AI

Tools

Kafka

MongoDB

AWS

Docker

Kubernetes

Job description

About Steer Health

Steer Health is the AI-native growth and automation platform for healthcare. Health systems, hospitals, and specialty medical groups use our platform to attract and convert patients, automate front-office and clinical workflows, and accelerate revenue. Our AI agents answer calls, book appointments, document visits, and close operational gaps around the clock, connected directly to the systems clinicians already use.

The platform integrates with 36 EHRs, including direct Epic integration with SSO, and serves provider organizations nationwide, covering millions of patient lives. Steer Health is a KLAS Emerging Solutions Top 20 company, an athenahealth Marketplace certified partner, and winner of the 2026 Hearst Health Prize.

The Role

We are hiring a Senior Backend Engineer to design, build, and scale the core services behind our platform. You will work on event-driven pipelines that move clinical and operational data in real time, integrations with EHRs and third-party systems, and the backend infrastructure that powers our AI agents. This is a high-ownership role: you will take problems from architecture through production and operate what you ship.

What You Will Do

• Design, build, and operate backend services and APIs in Node.js and TypeScript
• Architect and extend our event-driven systems on Kafka, including topic design, producers and consumers, stream processing, delivery guarantees, and back-pressure at scale
• Own MongoDB data modeling and performance, including schema design, indexing, aggregation pipelines, replication, and query optimization
• Build reliable, secure integrations with EHRs, healthcare data standards (FHIR, HL7), and third-party APIs
• Support AI agent workflows with fast, resilient backend services and real-time data pipelines
• Drive reliability and observability: monitoring, alerting, load testing, incident response, and postmortems
• Handle PHI responsibly and uphold HIPAA-grade security practices across every service you touch
• Raise the engineering bar through design docs, code reviews, and mentoring

Must-Have Qualifications

• 5+ years of backend engineering experience with clear senior-level ownership of production systems
• Expert-level Node.js and TypeScript in production environments
• Hands-on experience designing and operating Kafka-based eventing architectures
• Deep MongoDB experience at scale, including schema design, indexing strategy, and performance tuning
• A track record of building and scaling systems at a high-growth or high-traffic company
• Strong API design fundamentals and disciplined habits around testing, code quality, and documentation Strongly Preferred
• Healthcare or health tech background, including EHR integrations, FHIR or HL7, HIPAA, and PHI handling
• Experience at a high-scaling technology company where reliability and throughput were mission critical Nice to Have
• Cloud infrastructure experience (AWS preferred), Docker, and Kubernetes
• Redis or other caching and search layers
• Exposure to LLM or AI product pipelines
• Early-stage startup experience and comfort with ambiguity Our Stack

Node.js, TypeScript, Kafka, and MongoDB, with Next.js on the front end and a purpose-built eventing engine at the core of the platform.

Why Join Steer Health

• Build AI that measurably improves how patients access and receive care, at real scale
• High ownership and direct access to the founding team; your work ships fast and matters
• Award-winning product with strong market momentum
• Competitive salary, equity, and benefits

Steer Health is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all