Senior Backend Engineer

At SAIVA AI, we are transforming senior and post-acute care by turning millions of real-world electronic health data points into timely, actionable clinical insights. Our solutions empower thousands of healthcare professionals across the United States to identify patient risks earlier and make data-driven interventions for vulnerable populations.

Based in Silicon Valley, our team brings together experienced healthcare technology leaders, engineers, and data scientists. We use advanced technology to improve care and help healthcare professionals make better-informed decisions.

Position Description

• We are seeking a hands-on Senior Backend Platform Engineerwith strong experience designing backend systems, operating production workloads on AWS, and working with large relational databases.
• You will design, build, and operate the backend services and shared platform capabilities that power SAIVA's healthcare applications. This includes Python services, APIs, application databases, asynchronous workflows, AWS architecture, and production reliability.
• We are looking for an engineer who can evaluate technical requirements, design scalable solutions, explain architectural tradeoffs, and take ownership from initial design through production operation.
• This role owns backend services, APIs, application databases, and their AWS runtime. You will collaborate with Data, UI, and Mobile teams through well-defined contracts and integrations, while those teams retain ownership of data pipelines, machine learning models, and user interfaces.
• This is a senior individual-contributor role without direct people-management responsibility. The engineer will independently own significant backend and platform initiatives while collaborating with engineering leads and cross-functional teams.

Key Responsibilities

• Design, build, test, and operate scalable Python backend services and shared platform capabilities.
• Develop secure, versioned, and well-documented APIs for internal, web, mobile, and partner applications.
• Actively contribute to system-design discussions and decisions involving service boundaries, data models, API contracts, asynchronous workflows, and integration patterns.
• Design systems for scalability, fault tolerance, idempotency, concurrency, graceful failure, and recovery.
• Build and operate AWS services.
• Design and optimize PostgreSQL, indexes, queries, transactions, connection strategies, and migrations.
• Diagnose application and database performance issues involving query plans, blocking, locks, deadlocks, and resource contention.
• Partner with DevOps on CI/CD, infrastructure, deployments, monitoring, scaling, backups, and production support.
• Improve platform reliability, observability, security, performance, and AWS cost efficiency.
• Troubleshoot production incidents, lead root-cause analysis, and implement preventive improvements.
• Apply security, privacy, auditability, HIPAA, and SOC 2 requirements throughout platform design.
• Use approved AI-assisted and agentic development tools to accelerate design, implementation, testing, debugging, and documentation.
• Participate in code reviews, share technical knowledge, and contribute to backend and platform engineering standards.

Must-Have Qualifications

• 5+ years of professional experience designing, building, and operating backend or platform systems in production.
• 3+ years of professional Python development experience using FastAPI.
• Strong system-design experience covering distributed systems, microservices, APIs, asynchronous processing, and failure recovery.
• Demonstrated ability to evaluate architectural tradeoffs and translate requirements into practical technical designs.
• Strong hands-on experience operating production workloads on AWS.
• Experience with core AWS services such as ECS/Fargate, ALB, RDS, S3, SQS, and CloudWatch.
• Strong SQL skills and production experience with PostgreSQL, SQL Server, or another major relational database.
• Strong understanding of relational data modeling, indexing, query plans, transactions, locking, and performance optimization.
• Experience designing secure RESTful APIs, service integrations, and asynchronous workflows.
• Experience with Docker, containerized services, automated testing, and CI/CD.
• Experience with monitoring, observability, performance troubleshooting, incident response, and root-cause analysis.
• Experience using AI-assisted or agentic development tools as part of a daily engineering workflow.
• Strong communication skills and a record of independently owning systems from design through production support.

Preferred Qualifications

• Production experience with both PostgreSQL and Microsoft SQL Server.
• Experience supporting large databases or high-volume transactional workloads.
• Experience building multi-tenant SaaS platforms or reusable shared services.
• Experience with Terraform, AWS CDK, CloudFormation, or another infrastructure-as-code framework.
• Familiarity with ECS, Redis, caching strategies, or distributed locking.
• Experience with healthcare systems, EHR integrations, HIPAA, SOC 2, or another regulated environment.

Daily Breakdown

• 65% Hands-on backend and platform development
• 15% System and database design
• 10% Reliability, performance, and production support
• 10% Cross-team collaboration and code reviews

SAIVA AI Offers

• Competitive compensation and stock options
• Medical, Dental, and Vision Insurance
• 401(k) Plan
• Paid Time Off

SAIVA AI is an equal opportunity employer and is committed to diversity and inclusion in its hiring and business practices.