Backbone Software
Founding Engineer, Backend & Infra
San Francisco · Exec
Sponsorship not specifiedDetected 50 days ago
RailsDistributed SystemsBackend DevelopmentMachine LearningData EngineeringLLMsPatient CareResearch
About the role
- FOUNDING ENGINEER, BACKEND & INFRASTRUCTURE ABOUT BACKBONE Care should be paid for the moment it's delivered.
- As a result, patient care is delayed, clinicians burn out, margins crater, and hundreds of billions of dollars that should be funding care end up funding the friction itself.
- We're backed by Andreessen Horowitz (a16z), Lightspeed, Hanabi, and a roster of operators and clinicians who have built and run the largest payers, providers, and healthcare technology platforms in the country.
Responsibilities
- As a founding engineer, you'll own the systems that make Backbone work: chart ingestion, document processing, claims workflows, browser and computer-use automation, payer portal navigation, orchestration, queues, reliability, auditability, and the infrastructure needed to scale from thousands of charts and claims to hundreds of thousands.
- Build and scale the distributed systems that power Backbone's clinical and financial workflow
- own backend services across chart data, claims data, authorization workflows, denial workflows, and payer/provider integrations
- Build orchestration infrastructure for long-running, failure-prone workflows across EHRs, practice management systems, clearinghouses, and payer portals
- Build observability, retry, audit, and human-in-the-loop infrastructure for high-stakes production workflows
- Partner with product and research engineers to take new clinical intelligence capabilities into production, and set the engineering patterns that future engineers will inherit
- Build and scale the distributed systems that power Backbone's clinical and financial workflow; own backend services across chart data, claims data, authorization workflows, denial workflows, and payer/provider integrations
- chart ingestion, document processing, claims workflows, browser and computer-use automation, payer portal navigation, orchestration, queues, reliability, auditability, and the infrastructure needed to scale from thousands of charts and claims to hundreds of thousands.
- Backbone is dismantling this friction, building intelligent financial rails atop clinical AI research to facilitate instant payments between payers and providers.
Requirements
- 3+ years of professional software engineering experience shipping production systems end-to-end
- Generalist range across backend, data, and ML, alongside real LLM experience in production
- Comfort with distributed systems, microservices, queues, workflow engines, data pipelines, or large-scale backend infrastructure
- Your work will touch product decisions, system architecture, user experience, and the core automation engine behind Backbone.
Compensation
- We offer competitive compensation, meaningful ownership, and the opportunity to build foundational technology in a massive, broken, high-impact industry.
Benefits
- Work on browser-use and computer-use systems that navigate complex medical software and payer portals
- Design reliable systems for messy healthcare data: scanned charts, PDFs, structured claims, unstructured notes, attachments, policies, and operational state
- Healthcare experience is helpful, but not required.
- turning fragmented healthcare workflows into software that actually helps people do their jobs faster and better.
- At Backbone, we're making that possible for the first time by building the clinical AI layer for healthcare payments.
Company info
- We offer competitive compensation, meaningful ownership, and the opportunity to build foundational technology in a massive, broken, high-impact industry.
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This listing is sourced directly from Backbone Software's careers page and normalized into a canonical job model.