Senior Backend Engineer, Infrastructure [Remote]

Ellipsis Health is creating cutting-edge AI/ML products that solve healthcare staffing challenges and administrative burdens using conversational AI and our patented vocal biomarker technology, helping deliver better healthcare experiences for clients and patients. We are headquartered in Silicon Valley and are funded and supported by preeminent venture capital groups and healthcare institutions.

In this role, you will be a core contributor on our AI Research & Engineering team, building the real-time voice infrastructure behind our conversational AI products. You will design and run the Python micro-services that power live voice conversations, from audio capture and streaming transcription to LLM logic, synthesis, and playback. You will work with ML, product, data engineering, and client-SDK teams to deliver secure, low-latency, HIPAA-compliant clinical applications.

Responsibilities:

Real-Time Voice Pipeline: Expand and maintain our real-time voice pipeline by designing, implementing, and maintaining Python micro-services for conversational AI orchestration, including audio capture, streaming transcription, prompt/LLM logic, synthesis, and playback.

Providers, Transports & APIs: Integrate new providers and transports by adding plug-ins for emerging ASR, TTS, LLM, and memory services; wiring up WebRTC, SIP, or phone endpoints; and building adapters that allow hot-swapping components without downtime. Build API endpoints.

Ultra-Low Latency: Deliver sub-500 ms round-trip latency by profiling async pipelines (asyncio, FastAPI, gRPC) and optimizing buffering, concurrency, and back-pressure handling.

Observability: Instrument and observe every hop by emitting structured traces (OpenTelemetry), metrics, and logs for each pipeline stage, and define SLOs for first-token latency, end-to-end latency, and streaming reliability.

Production Hardening: Implement graceful retries, idempotent message passing, circuit breakers, and HIPAA-compliant security (encryption in transit, per-tenant isolation, secrets rotation).

Cross-Functional Collaboration: Work with ML, product, data engineering, and client-SDK teams to deliver features such as voice cloning, multimodal hand-offs, and domain-specific memory retrieval.

Minimum Qualifications:

• 4+ years building production back-ends in modern Python.

• Proven experience with real-time streaming systems (WebRTC, WebSockets, or gRPC streaming) and proficiency with asyncio, FastAPI, or similar async frameworks.

• Deep understanding of concurrency, buffering, audio codecs (Opus, PCM), and distributed tracing.

• Solid understanding of AWS/GCP/Azure, including container orchestration (Kubernetes/EKS/GKE), message queues (Kafka/SQS/Pub/Sub), and IaC (Terraform).

• Solid grasp of relational (PostgreSQL) and in-memory (Redis) data stores, with the ability to model and persist conversational state.

• Excellent communication skills and a bias for measured, observable, and continuously deployable software.

Preferred Qualifications:

• B.S./M.S. in Computer Science, Electrical Engineering, or a related field.

• Familiarity with voice-agent frameworks.

• Hands-on experience with telephony (Twilio, Telnyx), SIP, or PSTN integrations.

• Experience integrating multimodal inputs (vision, text chat) into voice agents.

• Familiarity with GPU inference and streaming pipelines.

• Prior work in regulated industries (healthcare, finance) and comfort preparing for SOC 2 / HIPAA audits.

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 $250,000 USD , depending on skills, qualifications, and relevant experience.

Background Checks:
As a health technology company, we reserve the right to run background checks on candidates to whom we extend offers, in compliance with applicable laws. We evaluate candidates holistically and comply with all “ban the box” regulations.

Assistance:
If you have a disability or require accommodations during the application or recruitment process, please contact View email address on jobs.ashbyhq.com .