Staff Software Engineer - Backend/Infra [NYC or SF]

Concurrence; San Francisco (CA); On-site; USD 210,000 - 260,000; Full time

Benefits offered by this job

Health insurance

Catered meals

Mental health support

Wellness stipend

Learning budget

Conference attendance

Team offsite

Academic collaboration

Unlimited PTO

Job summary

Concurrence is building the clinical AI infrastructure powering patient-facing care on a scalable backend platform. This Staff Backend/Infra Engineer role focuses on high-throughput services for millions of conversations monthly, owning core platform services end to end and ensuring reliability and clean design.

You will work on systems that process sensitive healthcare data, improving performance, observability, and overall health of the platform while guiding architectural decisions as the

Qualifications

• Experience building production backend systems at scale.
• Ownership of outcomes in large-scale backend environments.
• Strong background in concurrency and distributed system design.
• Ability to debug across services, queues and databases.

Responsibilities

• Designing high-throughput services that handle concurrent conversations at scale
• Owning a core platform service from design to production
• Building systems that stay available and degrade gracefully when things fail
• Handling sensitive healthcare data with the care it requires
• Improving performance, observability, and operational health across services
• Shaping architectural decisions as the platform grows
• Think carefully and holistically about system design under time pressure.

Skills

Concurrency

Distributed systems

Service design

Debugging across services

Job description

About Concurrence

At Concurrence, we’re building the clinical AI infrastructure that health systems, life sciences companies, payors, and government agencies run their patient-facing care on. Our agents work across the whole patient journey: pre-visit intake, care navigation, post-visit care plans, and ongoing monitoring. Our mission is to make excellent care accessible to every patient, not rationed by the limits of clinician time.

This hasn’t been solved because the underlying record was never built for it. EHRs were designed for billing, not for systems that learn. So instead of layering another point solution on top, we’re rebuilding the medical record as a timeline of clinical events and running agents on top of it that improve with every patient interaction. Unlike single-purpose chatbots or scribes, Concurrence is the platform our customers use to build their own agents. That means our work has to hold up across specialties, workflows, and regulatory environments and not just one narrow use case.

Our agents have supported more than 10 million patient encounters and are on track to grow tenfold this year. Our work is validated through partnerships with leading academic medical institutions. We’re fresh off our Series A, backed by Tier 1 VCs such as Madrona, General Catalyst, and Optum Ventures.

We’re a small team of around 35 people, working in person in New York City and San Francisco. We care deeply about craft, clinical rigor, and the speed at which good ideas reach patients. If you want your work to be measured in outcomes rather than releases, we’d like to hear from you.

About this role

As a Staff Backend/Infra Engineer at Concurrence, you’ll build the core services behind our agent platform. The systems you own handle millions of conversations a month, so concurrency, reliability, and clean design are the job itself, not an afterthought. You’ll own services end to end, from design through production.

What you’ll do

• Designing high-throughput services that handle concurrent conversations at scale

• Owning a core platform service from design to production

• Building systems that stay available and degrade gracefully when things fail

• Handling sensitive healthcare data with the care it requires

• Improving performance, observability, and operational health across services

• Shaping architectural decisions as the platform grows

• Think carefully and holistically about system design under time pressure.

What we’re looking for

• You’ve built and operated production backend systems at scale and owned the outcome

• You’re strong with concurrency, distributed systems, and service design

• You prefer simple, maintainable solutions to hard problems

• You debug well across services, queues, and databases

• You’re low ego, direct, and hold yourself to a high bar

• You can work on site in New York City or San Francisco

Nice to have

• Experience in a regulated or high-reliability domain (healthcare, finance, legal)

• High-throughput or low-latency system design

• Experience with production AI or ML systems

Benefits (available to Full-Time Employees)

Health & Wellness

• Comprehensive health, dental, and vision insurance

• Daily catered lunch and dinner

• Mental health support and wellness coaching

• Flexible wellness stipend for fitness, therapy, or personal growth

Growth & Development

• Annual learning budget for courses, books, or conferences

• Conference attendance budget for professional development

• Annual team offsite

• Academic collaboration opportunities

• Unlimited PTO

Our Core Values

1. Patients Win, We Win

2. High Standards, High Care

3. Thoughtful Urgency

4. Intensely Measured

Who Builds With Us

• Low ego: Politics and territory don’t interest you. The best ideas win, regardless of who has them.

• Direct: You say the hard thing, challenge ideas openly, and commit fully once decided.

• High agency: You thrive on trust rather than instruction. When you see something is broken, you fix it. You don’t file tickets and wait for someone else.

• Bar of excellence: You hold yourself to a bar most people wouldn’t, and you want teammates who do the same.

• Skeptical: You push back on rules that don’t make sense and question assumptions that haven’t earned their place.