Senior Backend Engineer (Typescript)

About Alaffia & Our Mission

Every year, U.S. health plans lose billions to improper payments and administrative waste. That wasted spending ultimately trickles down across the healthcare ecosystem, driving up costs for plans, providers, and patients alike. We’re here to change that paradigm.

Alaffia is a new kind of claims operations partner for health plans. Using expert clinicians and transparent AI, we deliver deeper insights, smarter automation, and consistently better outcomes across the entire lifecycle of claims. With Alaffia, health plans can cut wasted spending more effectively than ever — and provide their members the most affordable care.

We’re a high-growth, venture-backed Series B healthtech startup based in NYC and are actively scaling our company. Join us in helping to build a healthcare system that works better for everyone.

*This position requires current authorization to work in the United States. Unfortunately, we are not in a position to sponsor work visas at this time.

About the Role & What You'll Be Doing

Alaffia is a healthcare AI startup revolutionizing health and data automation. Our AI-driven platform leverages state-of-the-art generative AI and machine learning technologies to enhance accuracy, efficiency, and compliance in medical billing and auditing. As we scale, we are seeking a Senior Backend Engineer to build the cutting‑edge AI solutions, drive innovation, and shape the future of healthcare automation.

We are looking for a talented full stack engineer who is passionate about building modern web applications and scalable systems. Our platform leverages cutting‑edge technologies to revolutionize healthcare administration workflow. We seek someone who thrives on solving complex frontend and backend challenges, from crafting intuitive user interfaces to designing robust API architectures. You will have the opportunity to work with Typescript, React, GraphQL, PostgreSQL and latest cutting edge AI technologies while implementing features that directly impact healthcare organizations. In this role, you'll be building the future of healthcare automation while tackling challenging problems in web development, system design, and cloud infrastructure.

Key Skills & Qualifications

Code Fluency

• Write code that captures the essential nature of the solution and is appropriately flexible, reusable, efficient, and adaptable to changing requirements.




• Provide high quality code review feedback and adopt approaches to foster effective and collaborative code review culture.




• Strong awareness of the technologies used by the team and the ecosystem around these technologies and able to introduce new ideas to solve business and technical problems.




• Responsible for successful delivery of their projects, including planning, risk management, design, development, testing, rollout, and maintenance.




• Identify ways to simplify application code/infrastructure and improve developer efficiency as measured by cycle time, ramp‑up time, or other similar measurements.




• Experience with enterprise codebases and the ability to onboard into an established product.




• Preemptively identify and resolve technical risks before they jeopardize the project. Resolve cross‑team dependencies earlier to ensure the successful execution of the project.




• Avoid re‑inventing the wheel by leveraging other Alaffia Health solutions or off‑the‑shelf solutions with the possible trade‑off in mind.

Software Design

• Responsible for designing the software or systems in the owned area and ensuring that they meet their design objectives.




• Give quality feedback on designs written by other members of the team, asking probing, insightful questions that solidify choices and surface erroneous assumptions.




• Effectively and quickly debug cross‑module issues, and may intuit where bugs might lie due to deep knowledge of the libraries, platforms, and systems that the software relies on.

Architecture Design

• Create coherent designs with multiple components interacting across API or system boundaries; bugs do not creep in at the boundaries between components due to mismatches in expectations of what is technically feasible.




• Capable of rolling out a component or major feature (and deprecating an existing system or feature) reliably - including appropriate monitoring, paging, etc are in place, and that failure domains are understood and characterized appropriately, avoid introducing toil and future maintenance work by proactively avoiding scaling issues and providing adequate documentation before large scale rollout. For early stage products, roll out with an eye toward achieving learning goals untainted by poor quality and know when to make appropriate tradeoffs for “failing fast”.




• Design clear success metrics and achieve those metrics consistently post‑launch through the lifetime of the system or feature. For early stage products, those success metrics may be oriented around learning goals rather than usage goals, given the inherent unpredictability of achieving product/market fit.

Business Acumen

• Engage in listening sessions to increase learning to guide work/priorities




• Have a working knowledge of Alaffia Health’s strategy and organization structure to work effectively across the org and able to help other engineers to effectively collaborate effectively

What We're Looking For

• Demonstrated experience designing, developing, and deploying fullstack applications using Typescript, Node, GraphQL, PostgreSQL, React and Next.js in a production environment.




• Experience building SasS in the healthcare sector




• 5+ years industry experience with large scale system




• Building and deploying user facing AI products




• Experience with DevOps and cloud providers, such as AWS, Azure, and GCP




• Hands on experience with Postgres databases and data model design.




• Implementing robust testing suites to verify the correctness of new and existing features using testing frameworks




• Developing observability frameworks that include logging and user activity metrics to integrate with Datadog and other observability tooling




• Leading and engaging in architectural decisions that enable scalability, maintainability and extensibility to support business growth and user needs




• Autonomous learning, self‑leadership, and the ability to own system components while collaborating with other SME’s




• Excellent communication and collaboration skills, with the ability to articulate complex technical concepts to non‑technical stakeholders.

Our Culture

Alaffia was born out of our founders’ personal connection to the inefficiency of the U.S. healthcare system. We are deeply mission‑driven, with an abiding belief that technology can help create a better future for everyone —and we’re looking for others who share our passion for change to join the team.

What Else Do You Get?

• Competitive compensation package (cash + equity)




• Medical, Dental and Vision benefits




• Flexible, paid vacation policy




• Work in a flat organizational structure — direct access to Leadership

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