Backend and AI Infrastructure Engineer

San Francisco, CA

• On-site
• Full-time Compensation: $120,000–$250,000 + equity (0%–2%)
  
  
  

About The Company

An early-stage, venture-backed healthcare AI company building the agentic intelligence layer for healthcare. Its AI agents read, reason over, and adjudicate complex clinical cases in real time, automating administrative clinical work and pushing decisions directly into payer systems — already processing tens of thousands of requests per month. The company reached $1M+ in revenue within four months of commercialization and has grown ARR roughly 10x over the past six months.

Founded 2024

• 11–50 people
• Industry: Healthcare
  
  
  

The Role

Own and scale the backend and AI infrastructure behind an agentic clinical-decision platform, supporting rapid customer onboarding and growth in a production healthcare environment. You'll architect AI-native systems, drive product iterations end-to-end, and own critical backend infrastructure, with the opportunity to build and manage your own engineering team as the company scales.

What You'll Be Doing

• Architect and deploy AI-native systems to support large data volumes via API

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• Shape the next product iterations end-to-end, integrating first-hand customer feedback
• Build reliable and secure agentic infrastructure for processing clinical information of millions of patients
• Work with an experienced team of ex-founders, operators, and clinicians
  
  
  

Tech stack: Python-centric backend; infrastructure-as-code (Terraform or similar); LLM and agentic tooling.

Requirements

• Proficient in Python (hard requirement)
• Infrastructure as code experience (Terraform or similar - hard requirement)
• Understanding of prompt engineering
• Strong GitHub contribution profile with active commits
• Currently employed in a role at an established company (not unemployed, not running own consultancy)
• Must be available to work in-person 5 days per week in San Francisco
  
  
  

Green Flags

• Competitive background in any domain (sports, esports, chess, coding competitions, Kaggle, etc.) - shows extraordinary ability
• Prior founding experience or startup experience
• Founding team member experience
• High agency and strong decision-making track record
• Experience with browser automation
• Active open source contributions
• Mix of IC skills with people management potential
  
  
  

Red Flags

• Not currently employed
• Running own consulting company rather than working at established company
• Short tenures/frequent job hopping
• Arrogant attitude
• Dishonesty or lying (especially about using AI tools like Claude during interviews)
• Only doing code reviews rather than hands-on coding

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• Lack of personal projects or side work
  
  
  

Why Join

• Real, fast traction with engineering as the primary growth constraint — high-leverage, high-ownership work
• Architect AI-native systems end-to-end and own critical backend infrastructure from day one
• Clear path into technical leadership as the team scales
• Strong resources: significant GPU access, latest Mac, and AI coding/chat assistants
• Full benefits: stock options, health/dental/vision, unlimited PTO, and visa sponsorship (H-1B, O-1)
  
  
  

Details

• Location — San Francisco, CA
• Work policy — In-person, 5 days/week
• Compensation — $120,000–$250,000 + equity
• Visa sponsorship — H-1B, O-1, OPT
• Employment type — Full-time
• Experience — 1+ years