Founding Senior Backend Engineer AI

Founding Senior Backend Engineer AI-Powered Healthcare Platform Compensation: $100-200k annually + Equity Location: San Francisco, CA (Hybrid, 3 days in office) Who Are We? We're an early-stage startup building a next-gen, AI-driven healthcare system designed to eliminate friction in patient care from scheduling and billing to provider communication and operational efficiency. Backed by top-tier investors, were a small, high-output team tackling one of the most complex and important industries on the planet. You'll work directly with the founding team to define the product, tech, and trajectory. What's In It For You? Ownership: Youll own the backend architecture of a platform serving thousands of patients. Impact: We're using AI to improve real people's healthcare experiences at scalethis isn't theoretical. Speed: No red tape. You ship fast, iterate faster, and your work goes live in days, not quarters. Tech Frontier: Build AI-first systems with LLMs, real-time event processing, and bleeding-edge infra. Team: Work with a group of builders whove led at YC startups, top-tier tech firms, and high-growth unicorns. Mission: Help fix a broken system by building one that actually works. What Will You Do? Architect and implement an event-driven backend using Node.js, Supabase (Postgres), and AWS. Build real-time patient/provider workflows powered by AIthink dynamic scheduling, intake, and automation. Design event pipelines to process structured operational data like call transcripts and metadata. Ensure availability, security, and HIPAA compliance across a high-throughput system. Collaborate cross-functionally with AI and frontend teams to deliver a seamless care experience. What Will You Need? 5+ years of backend engineering experience using Node.js, TypeScript, and PostgreSQL. Deep experience with event-driven systems and real-time data processing (Kafka, RabbitMQ, webhooks). Strong grasp of distributed system architecture and messaging infrastructure. Bonus points if you've worked with LLMs or in AI-integrated environments. Security-forward mindset experience in HIPAA or other regulated industries is a huge plus. High-velocity mindset ideally from YC startups, FAANG, or similarly fast-paced environments. Signs of technical depth: open-source contributions, fast career growth, or math/CS accolades (e.g., Olympiad, MIT/Harvard CS). You're comfortable in chaos, allergic to bureaucracy, and thrive with autonomy.