The RoleWe are hiring a Senior Backend Engineer to design, build, and scale the core services behind our platform. You will work on event-driven pipelines that move clinical and operational data in real time, integrations with EHRs and third-party systems, and the backend infrastructure that powers our AI agents. This is a high-ownership role: you will take problems from architecture through production and operate what you ship.
What You Will Do- Design, build, and operate backend services and APIs in Node.js and TypeScript
- Architect and extend our event-driven systems on Kafka, including topic design, producers and consumers, stream processing, delivery guarantees, and back-pressure at scale
- Own MongoDB data modeling and performance, including schema design, indexing, aggregation pipelines, replication, and query optimization
- Build reliable, secure integrations with EHRs, healthcare data standards (FHIR, HL7), and third-party APIs
- Support AI agent workflows with fast, resilient backend services and real-time data pipelines
- Drive reliability and observability: monitoring, alerting, load testing, incident response, and postmortems
- Handle PHI responsibly and uphold HIPAA-grade security practices across every service you touch
- Raise the engineering bar through design docs, code reviews, and mentoring
RequirementsMust-Have Qualifications- 5+ years of backend engineering experience with clear senior-level ownership of production systems
- Expert-level Node.js and TypeScript in production environments
- Hands-on experience designing and operating Kafka-based eventing architectures
- Deep MongoDB experience at scale, including schema design, indexing strategy, and performance tuning
- A track record of building and scaling systems at a high-growth or high-traffic company
- Strong API design fundamentals and disciplined habits around testing, code quality, and documentation
Strongly Preferred- Healthcare or health tech background, including EHR integrations, FHIR or HL7, HIPAA, and PHI handling
- Experience at a high-scaling technology company where reliability and throughput were mission critical
Nice to Have- Cloud infrastructure experience (AWS preferred), Docker, and Kubernetes
- Redis or other caching and search layers
- Exposure to LLM or AI product pipelines
- Early-stage startup experience and comfort with ambiguity
Our StackNode.js, TypeScript, Kafka, and MongoDB, with Next.js on the front end and a purpose-built eventing engine at the core of the platform.
BenefitsWhy Join Steer Health- Build AI that measurably improves how patients access and receive care, at real scale
- High ownership and direct access to the founding team; your work ships fast and matters
- Award-winning product with strong market momentum
- Competitive salary, equity, and benefits
