Senior Backend Engineer

Clarion

• $135K — $160K *
Healthcare
5 - 7 years of experience
Job Overview by Ladders

Qualifications

  • 5+ years of experience in backend systems design and scaling
  • Strong expertise in APIs, relational databases, async workflows, and distributed systems
  • High sense of ownership and responsibility for system outcomes
  • Excellent communication skills for cross-functional collaboration
  • Bonus: Familiarity with security, authentication, and HIPAA regulations

Responsibilities

  • Design, build, and own core backend systems powering Clarion's AI agents
  • Develop infrastructure for multi-step, asynchronous workflows with conditional logic
  • Manage high-stakes integrations with EHRs and legacy healthcare platforms via APIs
  • Create internal tools for quick deployment and customization of AI assistants
  • Implement and maintain HIPAA-compliant backend authentication and authorization architecture

Benefits

  • Opportunity to directly impact healthcare communication
  • Work alongside elite founders with deep industry knowledge
  • Experience in a rapidly growing startup with early-stage traction
  • Positive work culture with an emphasis on collaboration
  • Fast decision-making processes and clear communication throughout the hiring process
Full Job Description
What You'll Own
  • Core backend systems: Design, build, and own the services, data models, and business logic powering Clarion's AI agents and healthcare workflows.
  • Workflow orchestration: Build infrastructure for multi-step, asynchronous workflows-including agentic AI workflows with conditional logic, retries, and graceful failure handling.
  • Healthcare integrations: Own high-stakes integrations with EHRs and legacy healthcare platforms via APIs and RPA.
  • Platform foundations: Create internal abstractions and tooling that allow the team to deploy and customize AI assistants for new customers quickly and reliably.
  • Security and compliance: Implement and maintain backend authentication, authorization, and HIPAA-compliant architecture required for enterprise healthcare.


Interesting Technical Challenges
  • Generative AI at Scale: Design and operate production systems using LLMs with real-time monitoring, safety controls, and enterprise reliability.
  • Agentic workflows: Architect backend systems that coordinate AI agents across complex healthcare workflows with strong guarantees.
  • Enterprise reliability: Build systems supporting thousands of concurrent patient interactions with high uptime and fast incident detection.
  • Fragmented healthcare systems: Design resilient abstractions across modern APIs and legacy EHRs while maintaining security and compliance.


What We're Looking For
  • 5+ years of experience designing, building, and scaling backend systems in high-reliability production environments.
  • Strong backend expertise across APIs, relational databases, async workflows, and distributed systems.
  • High ownership and agency-you thrive in ambiguity and take responsibility for system outcomes.
  • Ability to communicate clearly, collaborate cross-functionally, and surface risks early.
  • Bonus: experience with security, auth, or regulated environments (HIPAA familiarity is a plus).

You'll be a great fit if you enjoy owning critical backend systems end-to-end, solving complex problems under real-world constraints, and building infrastructure that directly impacts patient care.

Interview Process

We move quickly and communicate clearly at every stage:
  • Intro Chat (30 min, Virtual): Background, role context, and mutual fit.
  • Technical Deep Dive (1 hr, Virtual): Backend systems and architecture with the CTO and a senior engineer.
  • Onsite Team Day (Half Day, NYC): Collaborate on real problems, present a past project, meet the team, and assess mutual fit.

Decisions are typically made within 24 hours of each stage.

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