Senior Backend Engineer – Global Healthtech (.NET / C#)

projecty; Cape Town; Remote; ZAR 1,116,000 - 1,283,000; Full time

Job summary

projecty is seeking a Senior Backend Engineer (Healthtech) to own backend services in a cross-functional team. You will design secure, scalable APIs, handle healthcare data, and contribute to long-term technical direction using Domain-Driven Design and SOLID principles.

The role requires 8+ years of backend experience with C#/.NET Core, ASP.NET, EF Core, and PostgreSQL. Collaboration with Product, UX/UI, QA, and DevOps is essential in a remote South Africa setup.

Qualifications

• 8+ years of backend engineering experience.
• Expert-level proficiency in C# and .NET Core.
• Strong experience with ASP.NET and Entity Framework Core.
• Relational databases experience (PostgreSQL preferred).
• Git experience in collaborative environments.

Responsibilities

• Designing and building APIs for frontend applications and external integrations.
• Managing complex, structured, and sensitive healthcare data.
• Contributing to architectural decisions grounded in Domain-Driven Design (DDD) and SOLID principles.
• Collaborating daily with Product Owners, UX/UI Designers, QA, and DevOps.
• Refining requirements, planning user stories, and estimating delivery.
• Conducting code reviews and mentoring team members.
• Continuously improving code quality, architecture, and engineering processes.

Skills

Backend engineering

C# / .NET Core

ASP.NET

Entity Framework Core

PostgreSQL

Git

GitLab

Docker

English communication

Tools

Git

GitLab CI/CD

Docker

Job description

Senior Backend Engineer - Healthtech (.NET / C#)

Remote (South Africa) | Full-Time | Salary Package: R100,000 - R115,000 per month
Includes: base salary, employer retirement contribution, monthly medical aid contribution

About the Company

Our client is a European healthtech startup building modern practice management software for healthcare professionals. They are building modern, intuitive practice management software that reduces administrative burden for medical professionals and enables deeper system-wide healthcare integration.

If you've ever used outdated legacy medical software and thought "there must be a better way," this is the team making it happen. Their mission: enable better healthcare experiences through thoughtful technology. They operate with strong values of ownership, excellence, integrity, and collaboration, and their lean, product-driven team focuses on building software used by healthcare professionals

The Role

We are looking for a Senior Backend Engineer (.NET / C#) to take a high-ownership role within a cross-functional product team.

You will build the core services layer of a sophisticated cross-platform application, designing secure, scalable, and maintainable backend systems that directly support healthcare delivery. This role goes beyond coding, it requires architectural input, mentoring teammates, and shaping the long-term technical direction of the platform.

What You'll Be Responsible For

• Designing and building APIs for frontend applications and external integrations
• Managing complex, structured, and sensitive healthcare data
• Contributing to architectural decisions grounded in Domain-Driven Design (DDD) and SOLID principles
• Collaborating daily with Product Owners, UX/UI Designers, QA, and DevOps
• Refining requirements, planning user stories, and estimating delivery
• Conducting code reviews and mentoring team members
• Continuously improving code quality, architecture, and engineering processes

Required Experience and Skills

• 8+ years of backend engineering experience
• Expert-level proficiency in C# and .NET Core
• Strong experience with ASP.NET and Entity Framework Core
• Solid experience with relational databases (PostgreSQL preferred)
• Strong Git experience in collaborative environments (branching, merge requests, conflict resolution)
• Experience in cross-functional Agile (Scrum) teams
• Comfortable with pair programming and code reviews
• Strong written and verbal English communication skills

Nice to Have

• Experience in regulated industries (healthcare strongly preferred)
• Familiarity with DDD and CQRS
• API-first and RESTful design experience
• Automated testing experience (TDD/BDD)
• Knowledge of FHIR and HL7 standards
• Strong PostgreSQL expertise
• GitLab CI/CD experience
• Docker experience
• General understanding of frontend fundamentals

Who This Role Is For

• Self-starters who can operate independently and own mission-critical systems
• Engineers who thrive in lean, high-accountability environments
• Individuals who care deeply about code quality and product impact

Tech Stack

C#, .NET Core, ASP.NET, EF Core, PostgreSQL, Git, GitLab, Docker, Visual Studio / Rider