Senior Backend Engineer, Core Services

Job-ID: 0d4e2278-4d3e-42b4-bdd6-7c5c0452fd7cLocation: San Francisco, California, United StatesEmployment type: FULL TIMEPosted: 2026-09-15Ellipsis Health is creating cutting-edge AI/ML products that solve healthcare staffing challenges and administrative burdens using conversational AI and our patented voice biomarker technology - helping deliver better healthcare for everyone.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 servicesArchitect and implement scalable APIs and microservices using TypeScript/Node to support conversational AI workflows and healthcare integrationsOwn services in production end-to-end, including deployment, monitoring, incident response, and continuous improvement of reliability and performanceLead the design and implementation of database schemas and data pipelines for structured and unstructured healthcare dataDesign and maintain secure integrations with healthcare systems, scheduling systems, and external platformsImplement and manage authentication and authorization across systemsIntegrate and manage identity and access management solutions such as ZitadelEnsure security, privacy, and compliance (HIPAA, FHIR, and related standards) across backend systemsOptimize systems for performance, reliability, and scalability, supporting high-volume, real-time workloadsBuild and maintain CI/CD pipelines, infrastructure automation, and observability for production servicesTroubleshoot and resolve complex production issues; participate in on-call or production support rotations as neededMentor junior engineers and contribute to engineering best practices, code quality, and architectural standardsStay current with emerging technologies and frameworks, applying them thoughtfully to improve product velocity and qualityQualifications:Bachelor's or Master's degree in Computer Science or equivalent practical experience5+ years of professional experience building backend applications with strong TypeScript/JavaScript expertiseStrong proficiency in TypeScript/JavaScript and Node.js for backend and API developmentExpertise in designing and consuming RESTful APIs and/or GraphQLSolid understanding of microservices architectures, distributed systems, and system designHands-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 handlingExperience building and maintaining CI/CD pipelines and production monitoring/alerting systemsExcellent collaboration and communication skills in cross-functional teamsNice to Have:Experience implementing role-based access control (RBAC) and fine-grained permission systemsFamiliarity with identity providers and access management platforms such as Zitadel, Auth0, or similarFamiliarity with healthcare data standards such as FHIR and HL7Experience with conversational AI, voice systems, or real-time systemsPrior experience working in health tech or other regulated industriesExperience building or operating large-scale distributed systemsExposure to DevOps practices, infrastructure-as-code, or site reliability engineering conceptsSalary and BenefitsWe 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.Background ChecksAs 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.AssistanceIf you have a disability or require accommodations during the application or recruitment process, please contact View email address on click.appcast.io.