Lead Full-Stack Engineer - Backend Focus

Role overview Help build the foundational platform and API layer that connects AI capabilities, data systems, and product frontends across a multi-clinic primary care organization. This is a lead-level full-stack role with substantial architectural scope, focusing on backend and service design while contributing to feature delivery end-to-end.

Responsibilities - Design and lead development of core backend services, REST and GraphQL APIs, and service-to-service integrations that connect layers of the AI product stack - Establish patterns for authentication, authorization, rate limiting, PHI access control, and audit logging, embedding HIPAA compliance into platform design from the outset - Define reusable patterns for integrating AI capabilities into product APIs, including LLM routing, streaming responses, tool orchestration, and model output handling - Build logging, monitoring, and alerting infrastructure so the platform is operable and debuggable at scale - Contribute to full-stack feature delivery using TypeScript and Next.js, from server-side APIs through rendered UI - Drive architecture reviews and define backend engineering standards that the broader engineering team builds upon

Requirements - B.S. or M.S. in Computer Science, Engineering, or related field (or equivalent experience) - 8+ years of software engineering experience with deep expertise in backend and platform engineering - Strong proficiency in TypeScript and/or Python for API and service development - Proven track record building scalable, production-grade REST or GraphQL APIs - Solid understanding of OAuth2/OIDC, API security patterns, and authorization model design - Working knowledge of HIPAA requirements, particularly secure transmission, storage, and access control for PHI - Experience with Next.js and React sufficient for full-stack feature contribution - Hands-on experience with AI-assisted development tools and LLM coding harnesses

Nice to have - Experience in healthcare, financial services, or other highly regulated industries - Exposure to event-driven architecture, microservices, or API gateway patterns at scale - Familiarity with AI/LLM integration patterns, including streaming APIs and tool-use orchestration - Experience in a greenfield or team-founding engineering environment

Benefits and work setup - Remote work setup with home internet meeting minimum speed requirements and a dedicated, distraction-free workspace for handling sensitive PHI - Occasional travel to designated IT hub cities (NYC, Louisville, Tampa, Fort Lauderdale, Dallas/Frisco, Boston, Washington D.C., Atlanta, Nashville, Chicago, or Charlotte) for training or meetings - Full-time schedule of 40 hours per week - Estimated base pay range of $155,200 – $213,400 per year, plus eligibility for a bonus incentive plan - Benefits package including medical, dental, and vision coverage, 401(k) retirement savings plan, paid time off, company and personal holidays, paid parental and caregiver leave, and short- and long-term disability plus life insurance - Equal opportunity employer with affirmative action policies for individuals with disabilities and protected veterans