Senior Software Engineer (Backend)

Counsel Health; Boston, New York (MA, NY); Hybrid; USD 150,000 - 210,000; Full time

Benefits offered by this job

Competitive salary + equity

Comprehensive healthcare

Unlimited PTO

Job summary

Counsel Health in a hybrid, East Coast setup seeks a Senior Backend Engineer to define the future of AI-powered, human-led healthcare. You will own core primitives: external APIs, health data models, retrieval infrastructure, and enterprise integrations.

This role scales our platform for enterprise clients, powers AI-driven clinical workflows, and shapes durable data architectures for high-frequency health signals with stability and long-term usability.

Qualifications

• 5+ years building production backend systems.
• Experience designing external-facing APIs.
• Strong data modeling with time-series data.
• Experience with distributed multi-tenant architectures.
• Comfort contributing to greenfield architectural design.

Responsibilities

• Design and evolve external API and embedded product layer with long-term stability and enterprise-grade craftsmanship.
• Evolve retrieval harness to support patient and clinical search across structured and unstructured data.
• Build reusable platform primitives for external partners embedding AI capabilities.
• Contribute to core data models unifying structured health records and time-series signals.

Skills

API craftsmanship

Distributed systems

Data modeling

Time-series data

Multi-tenant architecture

External APIs

Job description

About Counsel

Counsel’s mission is to multiply the world’s healthcare capacity. We believe in a future in which every person has a personalized, AI-enabled doctor always in their pocket. To accomplish this, we’re building the first fully-vertical, AI-native medical group from the ground up. We’ve redesigned the entire clinical stack with custom AI tools that make our in-house physicians 10x faster and smarter. [learn more on our blog]
Since our founding in 2023, we have formed partnerships with leading healthcare organizations and are on track to serve hundreds of thousands of patients on our platform within the next year. We have raised over $35M from a16z, Google Ventures, Pear VC and other top‑tier VC firms.
Our team combines deep expertise in medicine (Harvard, Mt. Sinai, Mass General, UCSF) and technology (MIT, Google, DeepMind, NVIDIA, Stripe, Meta) - and we’re looking for exceptional people to join us as we scale.

Join us as we build the future of AI in healthcare!

About The Role

We're looking for a Senior Backend Engineer to help define the future of AI-powered, human-led healthcare. You'll sit on our Platform & Integrations team, owning the core product primitives the rest of the company builds on: external APIs, health data models, retrieval infrastructure, and enterprise integrations.

This role is central to scaling our platform: supporting enterprise healthcare clients, powering AI-driven clinical workflows, and keeping distributed systems correct and reliable. Much of this is greenfield, especially how we model and operationalize longitudinal health data from wearables and external systems.

What You'll Do

• Design and evolve our external API and embedded product layer with long-term stability, disciplined versioning, and enterprise-grade craftsmanship

• Evolve our agentic retrieval harness to support patient and clinical search across structured and unstructured data, with strict permission and audit guarantees

• Build reusable platform primitives that let external partners embed and extend our AI capabilities, so every integration adds lasting platform leverage

• Contribute to core data models that unify structured health records, unstructured inputs, and high-frequency time-series signals

Who You Are

• Cares deeply about API craftsmanship and long-term system design

• Has built complex systems that external customers rely on

• Enjoys modeling messy real-world data, especially high-frequency signals, into clean, durable abstractions

• Has built comprehensive search or RAG systems at production scale

• Has helped scale early systems from 1 to 10 in a fast-paced environment

• Thrives in small, high-leverage teams where ownership is real

• Has a track record of maintaining and leveling up operational excellence across engineering organizations

What You Bring

• 5+ years building production backend systems, ideally in high-growth environments

• Experience designing and maintaining external-facing APIs used by customers or partners

• Strong data modeling instincts, particularly around time-series or high-frequency data

• Experience working with distributed systems and multi-tenant architectures

• Comfort contributing to greenfield architectural design while shipping pragmatically

Role location:

NYC - hybrid, Boston - hybrid, or East Coast - remote

What We Offer

• Impact: Be at the forefront and contribute to groundbreaking, AI-driven healthcare experiences, directly interface with execs at the world’s leading tech & healthcare orgs

• Growth: Significant opportunities for broad ownership and professional development within our rapidly scaling startup

• Compensation: Competitive salary + equity

• Benefits: Comprehensive healthcare, vision + dental, 401K, Unlimited PTO, Parental Leave

Our Values

• Patients come first.
  We are clinicians 1st, technologists 2nd. We act with patient trust/safety at the center of every decision.

• Innovate with optimism.
  We are optimistic as we build the future of care delivery from first principles. Challenge the status quo when needed, no sacred cows.

• Right answer wins.
  Debate openly and pick the strongest path. We optimize for the company, not functions. We win and lose as a team.

• Simplicity over complexity.
  We choose clear, elegant solutions and avoid adding complexity that does not serve patients or the team.

• Do fewer things, well.
  We focus, and hold ourselves to the highest bar and pursue excellence in those areas.

Counsel Health participates in E-Verify. All newly hired employees are processed through the E-Verify system to confirm employment eligibility.