Senior Backend Engineer, Forward Deployed

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.
• Experience building or operating large-scale distributed systems.
• 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.