Backend Engineer

Backend Engineer

HealthLeap processes billions of data points from hospital EHRs - labs, vitals, clinical notes, structured records - and turns them into real-time risk scores that clinicians rely on every morning. You'll build the backend systems and infrastructure that make this possible.

Why You

You've built systems that handle real scale - not toy projects, real data, real users, real uptime requirements. You've debugged distributed systems at 2am. You've dealt with messy third-party APIs that had no documentation. You're the person who figures things out when the docs don't help.

What You'll Do

• Build data pipelines that process millions of patient records daily
• Parse 50,000+ clinical notes per patient using LLMs - without hallucinating
• Own infrastructure on AWS and Kubernetes - deploy it, monitor it, fix it when it breaks
• Design systems for high concurrency and reliability - clinicians depend on this every morning
• Build feature engineering pipelines for ML models

What We're Looking For

• 5+ years backend engineering experience
• Deep experience with distributed systems and highly concurrent workloads
• Solid with databases, data pipelines, ETL processing
• Comfortable with AWS, Kubernetes, and infrastructure-as-code
• You figure things out - even when documentation doesn't exist

Nice To Have

• Experience with healthcare data standards (FHIR, HL7v2)
• Background in LLM infrastructure or applied AI systems

This Role Is Not For You If

• Startup unpredictability feels like chaos to you. We find it exciting.
• You need detailed specs before you start. We figure it out as we go.
• You've never owned something end-to-end. Here, you own outcomes, not tasks.
• You wait to be told what to do next. We need people who see what's needed and do it.
• You're looking for a 9-5 with predictable hours. We care about deep work and deep rest (we have a minimum leave policy), but when a hospital go-live is on the line, we show up - even if that means a 60+ hour week.
• You see collaboration as interruption. We see it as leverage. The best engineers here are constantly pulling each other in - quick Slacks, 5-minute calls, shared context. If you prefer to work in isolation, this isn't the right fit.

Interview Process

1. Intro call - Get to know each other
2. Technical - 1-2 interviews
3. Onsite - Coding, case study, team meet
4. Decision - Same week as onsite

We respect your time. If there's a fit, you'll know fast.

Compensation & Benefits

• Salary: $200,000 - $275,000 base
• Equity: Meaningful ownership in an early-stage company
• Healthcare: 100% of premiums covered
• PTO: Unlimited, with a recommended minimum of 20 days
• 401(k): 4% match
• Equipment: Laptop + budget for your home office

Location

San Francisco - in person. (Will cover relocation costs)

If you're passionate about applying frontier AI to real-world impact, join us in building healthcare's future.