This role sits on our provider engineering team, building the platform that connects our agents to the EHRs, scheduling systems, and phone systems inside health systems, provider groups, and FQHCs. You'll work across the provider teams within Ellipsis, partnering with AI engineering, product, deployment, and customer teams to make every new health system go-live faster and more reliable than the last.
We're seeking a Senior Full Stack Engineer to build the backbone our AI agents rely on. An agent is only as good as the systems it can act on, and in this role you'll design the APIs, integrations, data model, and durable workflows that connect our agents to EHRs, scheduling systems, and phone systems inside some of the largest health systems in the country. The role leans backend and API, but it's full stack and AI is part of the job: you'll design the tools LLM agents call, ship UI when a feature needs it, and work side by side with our AI engineers. In your first three months, you'll ship at least one major EHR or health system integration from spec to go-live, own a core platform service in production, and build reusable integration tooling that makes each new go-live faster than the last.
You'll work directly with our SVP of Engineering and engineering leads on a small team where your decisions shape the platform for years. The ideal candidate is a hands-on builder who takes ownership in ambiguous situations, holds a high bar for reliability and observability, and is motivated by making healthcare work better for patients.
Responsibilities- Design, build, and operate backend services and APIs (TypeScript/Node.js and Python) that power our AI agents and the applications around them.
- Build integrations with EHR and health system platforms using FHIR, HL7, and vendor APIs, so messy systems look simple to the rest of the platform.
- Build the agent tools: the APIs and functions LLM agents call to look up patients, book appointments, and process refills, with the reliability, idempotency, and observability that requires.
- Build and scale durable workflows and job pipelines (e.g., Temporal, queues) for outbound campaigns, scheduling, and reconciliation.
- Evolve and scale our application architecture, data model, and persistence layer as we onboard more health systems.
- Ship complete features across the stack, including React/TypeScript UI when needed.
- Own production, including CI/CD, monitoring, alerting, incident response, runbooks, and HIPAA-grade security and audit logging.
Qualifications- 5+ years of experience building production backend systems in TypeScript/Node.js and/or Python.
- Strong API design skills (REST, webhooks, async processing), along with relational databases (PostgreSQL) and distributed systems fundamentals.
- Experience integrating third-party systems and handling rate limits, retries, and partial failures gracefully.
- Experience with cloud and containers (GCP preferred; Docker; Cloud Run or Kubernetes).
- Comfort shipping frontend work when a feature calls for it.
- Curiosity about LLMs and agents. Experience building with them is a plus, and you'll get plenty of it here.
Preferred- Healthcare interoperability experience, including FHIR, HL7v2, and EHR vendor APIs.
- Experience with Temporal or similar workflow orchestration.
- Telephony or CPaaS experience (Twilio, SIP).
- Experience building tools or MCP servers for LLM agents.
- Security and compliance experience (HIPAA, SOC 2).
Salary and BenefitsWe offer a competitive salary and meaningful equity, along with comprehensive health, dental, and vision insurance, a 401(k) plan, and [learning budget / conferences / additional benefits].
The typical salary range for this role is $160,000 to $210,000 USD, depending on skills, qualifications, and relevant experience.
