Senior Backend Engineer – Real-Time Healthcare Platform

Piramidal (YC W24); New York (NY); On-site; USD 250,000 - 300,000; Full time

Job summary

Piramidal is seeking a backend engineer in New York to build and scale the infrastructure behind a real-time neural monitoring platform. The role demands ownership of production backend systems and collaboration with ML and security teams.

The position is full-time, based in the New York office (5 days a week) with travel to client sites and US work authorization required. You will shape data models, APIs, and observability to support hospital-grade reliability.

Qualifications

• 5+ years of building and operating backend systems in production.
• Own a problem from an ambiguous start to a running, monitored service, and explain decisions verbally and in writing.
• Real experience with event-driven or stream-processing systems: partitioning, checkpointing, backpressure, at-least-once delivery.
• Strong Python, including concurrency (threads vs. processes, asyncio) and testing.
• Proficiency with containerization and orchestration, preferably using Kubernetes.
• Solid relational database skills, from schema design to query performance.

Responsibilities

• Build and run Python and Go services that consume, transform, and serve real-time streams of neurological data.
• Design, maintain, and improve data models, ingestion pipelines and retention for high frequency time series data, from raw neurological data, to all time series derived from it.
• Build and extend the APIs behind clinical workflows.
• Work with ML engineers to take models from research to production inference, and keep them running there.
• Make the platform observable and dependable: metrics, alerting, capacity planning, and incident follow-up.
• Help build software to the standards of a regulated medical device, including cybersecurity, traceability and change control.

Skills

Python

Go

Concurrency

Testing

Kubernetes

Relational databases

Tools

Kubernetes

Docker

Job description

Piramidal is seeking a backend engineer in New York to build and scale the infrastructure behind a real-time neural monitoring platform. The role demands ownership of production backend systems and collaboration with ML and security teams.

The position is full-time, based in the New York office (5 days a week) with travel to client sites and US work authorization required. You will shape data models, APIs, and observability to support hospital-grade reliability.