Principal Backend Engineer

At Qualified Health were redefining whats possible with Generative AI in healthcare. Our infrastructure provides the guardrails for safe AI governance healthcare-specific agent creation and real-time algorithm monitoring working alongside leading health systems to drive real change.

This is more than just a job. Its an opportunity to build the future of AI in healthcare solve complex challenges and make a lasting impact on patient care. If youre ambitious innovative and ready to move fast wed love to have you on board.

Were looking for a Principal Backend Engineer to shape the technical direction and architecture of our generative AI healthcare SaaS platform. As one of the most senior individual contributors on our engineering team you will lead the design and evolution of critical backend systems solve complex technical challenges and establish engineering foundations that enable us to scale reliably and securely.

You will work closely with engineering product AI and security leadership to translate business priorities into long-term technical strategy drive high-impact initiatives across teams and make architectural decisions that balance rapid innovation with operational excellence.

This is a hands-on technical leadership role. You will work directly on our hardest engineering problems while multiplying the impact of engineers around you raising engineering standards and helping shape the technical culture of a rapidly growing organization.

• Technical Strategy & Architecture: Define and drive the long-term technical direction for our core backend systems and services. Establish architectural principles and guide critical technology decisions that enable scalability security reliability and sustainable growth.

• Cross-Team Technical Leadership: Identify and lead complex engineering initiatives spanning multiple teams. Build alignment around technical priorities resolve architectural disagreements and drive initiatives from early design through successful production operation.

• Hands-On Engineering: Design implement and review critical components of our backend infrastructure. Foster AI first culture. Lead by example through high-quality code thoughtful system design and deep technical problem-solving.

• Distributed Systems & Scalability: Architect resilient distributed systems APIs data services and asynchronous workflows capable of supporting growing enterprise workloads complex integrations and evolving product requirements.

• Reliability & Operational Excellence: Establish engineering practices that improve system reliability observability performance and operational efficiency. Partner with Platform and Infrastructure teams on service-level objectives capacity planning incident prevention and systemic improvements.

• Technical Mentorship: Mentor Senior and Staff engineers develop emerging technical leaders and foster a culture of technical rigor collaboration ownership and continuous improvement.

• Strategic Partnership: Collaborate with engineering product and business leadership to evaluate technical investments make build-versus-buy decisions manage architectural trade-offs and balance near-term delivery with long-term platform sustainability.

• Demonstrated track record of architecting building and operating complex large-scale backend or platform systems in production with measurable technical and business impact.

• Deep expertise in distributed systems including service architecture data consistency concurrency fault tolerance scalability and performance optimization.

• Expert-level proficiency in at least one modern backend programming language with the ability and willingness to work extensively in Python.

• Strong experience designing and operating cloud-native applications on AWS GCP or Azure with an understanding of infrastructure automation deployment practices and production operations.

• Deep understanding of API design data modeling databases asynchronous processing and modern backend architectural patterns.

• Ability to navigate ambiguity independently identify important technical problems and translate complex requirements into pragmatic scalable engineering solutions.

• Demonstrated ability to improve engineering effectiveness through architectural simplification reusable systems mentorship and technical standards.

• Ability to work on-site in our Palo Alto office three days per week.

• Experience designing building or operating production generative AI applications LLM-powered workflows or AI infrastructure.

• Experience building multi-tenant enterprise SaaS platforms with strong requirements for security isolation scalability and availability.

• Experience with Google Cloud Platform Kubernetes Terraform and modern monitoring and observability tooling.

• Experience building systems in regulated environments including healthcare financial services or other industries with stringent data privacy and security requirements.

• Familiarity with HIPAA SOC 2 or comparable security and compliance frameworks.

• Experience establishing technical foundations engineering standards and architectural direction in rapidly growing organizations.

This is an opportunity to join a fast-growing company and a world-class team that is poised to change the healthcare industry. We are a passionate mission-driven team building a category-defining product. We are backed by premier investors and are looking for founding team members who are excited to do the best work of their careers.

Our employees are integral to achieving our goals so we are proud to offer competitive salaries with equity packages robust medical/dental/vision insurance flexible working hours hybrid work options and an inclusive environment that fosters creativity and innovation.

Qualified Health is an equal opportunity employer. We believe that a diverse and inclusive workplace is essential to our success and we are committed to building a team that reflects the world we live in. We encourage applications from all qualified individuals regardless of race color religion gender sexual orientation gender identity or expression age national origin marital status disability or veteran status.

Pay & Benefits

The pay range for this role is between $230000 and $300000 and will depend on your skills qualifications experience and location. This role is also eligible for equity and benefits.

Join our mission to revolutionize healthcare with AI. To apply please send your resume through the application below.

Required Experience:

Staff IC