[Hiring] Senior Backend Engineer @Steer Health

Role Description

We 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

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

Requirements

• 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

Benefits

• 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

Company Description

Steer Health is the AI-native growth and automation platform for healthcare. Health systems, hospitals, and specialty medical groups use our platform to attract and convert patients, automate front-office and clinical workflows, and accelerate revenue.