Founding Backend Engineer

Founding Senior Backend Engineer (Data Platform / Integrations)

Location: New York City In-Person

The Opportunity

Our client is hiring a Founding Senior Backend Engineer to own the data platform end-to-end and build the team around it. This is a true founding role: you will define canonical data models ship the event backbone enable analytics/experimentation and create the integration architecture that makes adding EMR #5 configurationnot months of bespoke engineering.

If youre energized by unglamorous but high-leverage infrastructure (data modeling pipelines events integrations) this is a rare seat.

What Youll Own

1) Outcome Data Layer (Instrumentation Measurement)

Build the instrumentation layer that ties every agent decision to customer-level business metricse.g. client retention caregiver satisfaction authorization utilization hours erosion. This becomes the foundation for experimentation ROI claims ML improvements and product strategy.

2) Real-Time Event Backbone

Design an event-driven architecture where visit status changes clock-ins call-outs ranking decisions and workflow outcomes flow in real timeso internal systems (and future products) can consume events without constant EMR polling or rate-limit band-aids.

3) Integration Platform Canonical Models

Create canonical data models across WellSky HHAeXchange AlayaCare and Axxess so adding the next EMR is configuration-driven. This also unlocks revenue-cycle automation by enabling unified authorization and billing models.

4) Analytics & Experimentation Tooling

Build the warehouse tooling so engineers can answer: Did this change improve customer outcomes quickly and consistentlywithout writing one-off queries every time.

What Our Client Is Looking For

Youre likely a fit if you are:

• Systems-minded and data-opinionated: you treat data modeling as a craft and can explain why entities should relate a certain way
• Comfortable with messy reality: youre excited by pipelines joins ETL/ELT and cleaning inconsistent third-party data
• Event-driven by default: youve built (or deeply understand) real-time architectures streaming/event backbones and durable systems
• Integration-savvy: youve shipped platforms that unify multiple external systems into clean internal abstractions
• AI-native and curious: you naturally look for leverage (LLMs for parsing/structuring automation for data QA agent-based extraction when APIs dont exist)

Bonus signals

• Experience with healthcare workflows EMRs/EHRs home health or revenue-cycle concepts (authorization billing reimbursement)
• Familiarity with healthcare data modeling standards (e.g. FHIR-style entity thinking)
• Experience building experimentation frameworks or measurement systems tied to business outcomes
• Background in data platform teams (data engineering backend/platform) at high-growth startups

What Success Looks Like (The Arc)

Q2: Ship the outcome data layer real-time event backbone. Make experimentation and measurable ROI a default.
Q3: Deliver the integration abstraction canonical models. EMR #5 becomes configuration. RCM roadmap becomes real.
Year-end: Youve built and are leading a 35 person data platform team (integration data engineering analytics). Youre operating as the Head of Data Platform.

Why This Role

• Founding-level ownership on a platform that directly drives revenue outcomes
• Complex high-impact systems work: data events integrations measurement experimentation
• Clear path to technical leadership and building a team
• Real customers real workflows and real-world leverageyour architecture decisions compound fast

Required Experience:

IC