Senior Backend Engineer, Core Services

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 primarily on backend services and APIs, collaborating closely with AI/ML engineers, product managers, and other engineers to deliver secure, reliable, and performant 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.

Responsibilities:

• Design, develop, and maintain end-to-end features across TypeScript-based backend services
• Architect and implement scalable APIs and microservices using TypeScript/Node to support conversational AI workflows and healthcare integrations
• Own services in production end-to-end, including deployment, monitoring, incident response, and continuous improvement of reliability and performance
• Lead the design and implementation of database schemas and data pipelines for structured and unstructured healthcare data
• Design and maintain secure integrations with healthcare systems, scheduling systems, and external platforms
• Implement and manage authentication and authorization across systems
• Integrate and manage identity and access management solutions such as Zitadel
• Ensure security, privacy, and compliance (HIPAA, FHIR, and related standards) across backend systems
• Optimize systems for performance, reliability, and scalability, supporting high-volume, real-time workloads
• Build and maintain CI/CD pipelines, infrastructure automation, and observability for production services
• Troubleshoot and resolve complex production issues; participate in on-call or production support rotations as needed
• Mentor junior engineers and contribute to engineering best practices, code quality, and architectural standards
• Stay current with emerging technologies and frameworks, applying them thoughtfully to improve product velocity and quality

Qualifications:

• Bachelor's or Master's degree in Computer Science or equivalent practical experience
• 5+ years of professional experience building backend applications with strong TypeScript/JavaScript expertise
• Strong proficiency in TypeScript/JavaScript and Node.js for backend and API development
• Expertise in designing and consuming RESTful APIs and/or GraphQL
• Solid understanding of microservices architectures, distributed systems, and system design
• Hands-on experience with cloud platforms (AWS, GCP, or Azure) and containerized deployments (Docker, Kubernetes)
• Strong database skills with SQL and NoSQL systems (e.g., PostgreSQL, MongoDB, DynamoDB)
• Deep understanding of security best practices, authentication/authorization, and secure data handling
• Experience building and maintaining CI/CD pipelines and production monitoring/alerting systems
• Excellent collaboration and communication skills in cross-functional teams

Nice to Have:

• Experience implementing role-based access control (RBAC) and fine-grained permission systems
• Familiarity with identity providers and access management platforms such as Zitadel, Auth0, or similar
• Familiarity with healthcare data standards such as FHIR and HL7
• Experience with conversational AI, voice systems, or real-time systems
• 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.