Senior Backend Engineer — Scalable APIs & AI Orchestration

Ellipsis Health; San Francisco (CA); Hybrid; USD 175,000 - 250,000; Full time

Benefits offered by this job

401(k) matching

Health, vision, and dental insurance

Flexible paid time off

Job summary

Ellipsis Health Inc. seeks a Senior Backend Engineer to design, build, and scale the core systems powering our conversational AI platform in a hybrid role based in the San Francisco Bay Area.

You will work across backend services, APIs, and orchestration layers with AI/ML engineers and product teams to deliver secure, reliable healthcare solutions, with emphasis on performance, security, and compliance.

Qualifications

• 5+ years backend development experience.
• Strong TS/Node.js for API services.
• RESTful API and/or GraphQL development experience.
• Experience building orchestration layers / workflow engines.
• Deep understanding of microservices architecture and distributed systems.
• Hands-on experience with cloud platforms (AWS, GCP, or Azure) and Kubernetes.
• Strong database design and management (SQL/NoSQL: PostgreSQL, MongoDB, DynamoDB).
• Security practices: authentication, authorization, encryption, secure data handling.
• Experience building and managing CI/CD pipelines.
• Own services in production end-to-end: deployment, monitoring, incident response.

Responsibilities

• Architect, develop, and maintain scalable APIs and microservices.
• Design, build, and manage orchestration services coordinating AI systems and external integrations.
• Optimize back-end performance for reliability and scalability.
• Ensure secure, HIPAA-compliant integration with healthcare systems (FHIR, EHRs).
• Collaborate with AI teams to deploy conversational AI workflows in production.
• Design and implement database schemas and data pipelines for structured and unstructured healthcare data.
• Build and maintain CI/CD pipelines to streamline deployments.
• Mentor junior developers and contribute to a high-quality engineering culture.
• Stay ahead of industry trends and improve platform performance and scalability.

Skills

TypeScript

Node.js

RESTful API

GraphQL

Orchestration / workflow engines

Microservices

Cloud platforms (AWS/GCP/Azure)

Kubernetes

SQL & NoSQL databases

Security best practices

CI/CD pipelines

Production ownership

Tools

PostgreSQL

MongoDB

DynamoDB

CI/CD tooling

Job description

If you’ve responded to an advertisement or been contacted by someone claiming to be from Ellipsis Health, you should be very careful and confirm that you are communicating with us by contacting us directly at [e-mail] . There have been several fraudulent job postings made by scammers pretending to be Ellipsis Health that are in fact totally unrelated to our company. You can learn more about job scams here: https://consumer.ftc.gov/articles/job-scams

Location

Employment Type

Full time

Location Type

Hybrid

Department

Compensation

• $175K – $250K

We are seeking a Senior Backend Engineer to help design, build, and scale the core systems powering our conversational AI platform. In this role, you will work across backend services, APIs, and orchestration layers, collaborating closely with AI/ML engineers, product managers, and other engineers to deliver secure, reliable, and scalable solutions for the healthcare industry.

Ellipsis Health is located in the San Francisco Bay Area, but we are open to remote candidates within the United States.

Key Responsibilities:

Architect, develop, and maintain robust, scalable APIs and microservices using TypeScript (Node.js) to support conversational AI workflows

Design, build, and manage orchestration services that coordinate workflows across AI systems, APIs, and external integrations

Optimize back-end systems for high performance, reliability, and scalability

Ensure secure and compliant integration with healthcare systems (e.g., EHRs, scheduling systems) while adhering to standards like HIPAA and FHIR

Collaborate with the AI team to deploy and manage conversational AI and NLP workflows in production environments

Design and implement database schemas and data pipelines for structured and unstructured healthcare data

Build and maintain CI/CD pipelines to streamline deployments and ensure high availability

Troubleshoot and resolve complex back-end issues with a focus on reliability and uptime

Mentor junior developers and contribute to a high-quality engineering culture

Stay ahead of industry trends and introduce technologies that improve platform performance and scalability

Qualifications:

5+ years of experience in back-end development with a proven track record of building secure and scalable systems

Strong proficiency in TypeScript and Node.js for API and service development

Expertise in RESTful API and/or GraphQL development

Experience building orchestration layers / workflow engines for distributed systems

Deep understanding of microservices architecture and distributed systems

Hands-on experience with cloud platforms (e.g., AWS, GCP, or Azure) and container orchestration (e.g., Kubernetes)

Strong database design and management experience (SQL and NoSQL), including PostgreSQL, MongoDB, or DynamoDB

Solid understanding of security best practices, including authentication, authorization, encryption, and secure data handling

Experience building and managing CI/CD pipelines

Own services in production end-to-end, including deployment, monitoring, incident response, and continuous improvement of reliability and performance

Preferred:

Experience integrating with Epic EHR, including SMART on FHIR, Epic APIs, or Epic App Orchard.

Familiarity with healthcare data standards such as FHIR and HL7.

Experience with conversational AI, voice systems, or NLP technologies.

Prior experience working in health tech or other regulated industries.

Exposure to DevOps practices, infrastructure-as-code, or site reliability engineering concepts.

Salary and Benefits:

We offer competitive salary and benefits, including 401(k) matching, health, vision, and dental insurance, and very flexible paid time off.

The typical salary range for this role is $160,000 to $210,000 USD, depending on skills, qualifications, and relevant experience.

As a health technology company, we reserve the right to run background checks on candidates to whom we extend offers, in compliance with applicable laws. We evaluate candidates holistically and comply with all “ban the box” regulations.

Assistance:

If you have a disability or require accommodations during the application or recruitment process, please contact [e-mail].