Senior Distributed Systems SWE

Acceler8 Talent; San Francisco (CA); Hybrid; USD 130,000 - 160,000; Full time

Job summary

Acceler8 Talent is looking for a Senior Distributed Systems Engineer with over 7 years of experience in software engineering. This hybrid position in San Francisco focuses on building systems for AI-powered clinical environments, impacting patient care directly. The role requires strong backend skills in Python, Go, or TypeScript, combined with experience in scaling systems and working with relational databases like Postgres. The company is recognized for rapid growth and innovation in healthcare.

Qualifications

• 7+ years of software engineering experience.
• Strong backend experience, preferably in Python, Go, or TypeScript.
• Deep experience with relational databases, Postgres preferred.
• Proven ability to scale systems and solve performance/reliability issues.
• Experience in owning infrastructure or platform systems end-to-end.

Responsibilities

• Design and scale database architecture including query optimization.
• Build caching systems to remove latency from critical user paths.
• Optimize system performance across high-traffic, real-time applications.
• Improve reliability and observability across core infrastructure.

Skills

Python

Go

TypeScript

Postgres

Performance optimization

Scaling systems

Reliability engineering

Tools

AWS

GCP

Job description

Senior Distributed Systems Engineer (7+ years)

Hybrid (3 days onsite) – San Francisco

This company is building AI-powered clinical documentation and decision support systems, transforming how healthcare is delivered.

Their platform operates in real-time during doctor-patient interactions, using AI to automate workflows, reduce administrative burden, and improve patient outcomes at scale.

Strong traction:

• $45M ARR with rapid growth toward $100M+
• Deployed across 50+ major U.S. health systems

Recognized as a LinkedIn Top Startup (2024 & 2025) and one of the top AI companies in healthcare.

The Role

This is a staff-level infrastructure role focused on building the systems that enable real-time, reliable AI in clinical environments.

You’ll own core platform components including database architecture, caching, and performance optimization - directly impacting latency and reliability in live healthcare workflows.

• Design and scale database architecture (Postgres, query optimization, indexing, capacity planning)
• Build caching systems to remove latency from critical user paths
• Optimize system performance across high-traffic, real-time applications
• Design rate limiting and load management systemsImprove reliability and observability across core infrastructure

Required Qualifications

• 7+ years of software engineering experience
• Strong backend experience (Python, Go, TypeScript, or similar)
• Deep experience with relational databases (Postgres preferred)
• Proven experience scaling systems and solving performance/reliability issues
• Experience owning infrastructure or platform systems end-to-end

Preferred Qualifications

• Experience with high-scale, low-latency systems
• Background in infrastructure, platform, or reliability engineering
• Experience in healthcare or regulated environments
• Startup experience with high ownership
• Python, Go, TypeScript
• Distributed systems + caching layers
• Cloud infrastructure (AWS/GCP)

Why This Role

• Real-world impact - systems directly affect patient care
• Frontier AI deployed in production
• Strong growth trajectory with clear path to IPO or acquisition
• High-caliber engineering team with strong ownership culture.