Midstream Health

Software Engineer, Systems

San Francisco

Sponsorship not specifiedDetected 175 days ago

Distributed SystemsBackend DevelopmentAWSGCPCloud PlatformsTerraformCI/CDAPI DevelopmentMachine LearningAgentic AISupply ChainLeadership

About the role

This is a rare opportunity to join Midstream at a formative stage and help shape the technical foundation of the platform.
From multi-tenant architecture and security boundaries to developer workflows and observability, you'll turn ambiguity into durable systems that reduce operational overhead and compound engineering velocity.

Responsibilities

Build shared platform patterns and tooling that help engineers ship new backend services and workflows quickly, safely, and consistently.
Design infrastructure that is clean, reviewable, and repeatable-reducing one-off configurations and enabling faster iteration.
Help ensure the team can spend more time building new capabilities-and less time maintaining systems-as customer usage and data volume grow.
Build the agentic orchestration layer for tools and and agents to power our natural language analytics that enables rapid discovery of insights with source document traceability.
You're comfortable building APIs, asynchronous workflows, background jobs, integrations, and foundational systems-balancing infrastructure leadership with delivering real product functionality.
Drive ideas from discovery to delivery with autonomy and trust.
You'll work at the intersection of product, systems, and cloud infrastructure, designing and building the distributed systems that allow a small team to move fast, safely, and with confidence as the company scales.
You'll partner closely with engineers and leadership to understand where infrastructure creates friction today, and where it will quietly break tomorrow if left unaddressed.
We're looking for a systems-minded software engineer who cares deeply about long-term maintainability and developer experience, but who also loves developing backend services and shipping a real software.
Someone who can reason about distributed systems, make pragmatic tradeoffs, and build infrastructure that fades into the background, so the team can stay focused on delivering meaningful product value.

Requirements

You have strong instincts for designing distributed systems and scalable SaaS platforms, with a focus on clear ownership, isolation, and reliability.
You know how to leverage cloud-native services for computing, storage, and ML-enabled applications as the platform grows.
You enjoy creating reusable patterns, templates, and automation that help teams ship faster with fewer operational burdens.

Benefits

Midstream is an AI-native financial operating system for health systems, founded by experienced entrepreneurs and backed by top-tier investors.
Purpose-built for healthcare's complexity, Midstream transforms structured, unstructured, and external data into instant, contract-aware insights that drive smarter decisions.
Our AI agents unify spend and revenue operations across the full back-office, learning and adapting with every interaction and delivering always-on intelligence that no point solution or one-off engagement can match.
The tempo of healthcare finance is changing, and Midstream is leading it.
Establish clear and scalable multi-tenant boundaries across data, compute, and identity to support enterprise healthcare customers.
Build technology that helps healthcare systems operate smarter and sustain care for more people.

Company info

Spend real time with customers, shaping a product that reflects their world.
User-focused culture: Spend real time with customers, shaping a product that reflects their world.

Apply directly at Midstream Health →Create a free account for alerts like this View Midstream Health immigration profile

This listing is sourced directly from Midstream Health's careers page and normalized into a canonical job model.