Ambience Healthcare
Staff Software Engineer, Distributed Systems
San Francisco · Staff+
Sponsorship not specified$226k-$283kDetected 262 days ago
TypeScriptPythonGoDistributed SystemsPostgreSQLPlatform EngineeringRESTDesign SystemsEHR/EMRResearch
Stay score
odds of building a lasting career here
59Sponsors, lottery-bound
Cap-exempt (no lottery)0
Sponsors this role80
Entry-level history0
PERM / green-card track0
Lottery odds (Level IV)94
Fits your clock70
Sponsors, but it's cap-subject — you still face the weighted lottery (~61% per draw at Level IV). Good if you win; have a cap-exempt backup on your list.
Lottery odds assume a STEM candidate.
Personalize to your clock →H-1B wage level
the lottery is wage-weighted — each level is one more entry
Level I$137,0931 entry
Level II$165,1312 entries
Level III$193,1493 entries
Level IV$221,1874 entries
This range already reaches Level IV — the maximum four lottery entries.
DOL prevailing wage, 2026-27 wage year · Software Developers (15-1252) · San Francisco-Oakland-Fremont, CA. Wage level is derived by USCIS from the offered wage, occupation and worksite; the occupation shown is inferred from the job title.
Employer immigration record
from this employer's Department of Labor filings
Files H-1B transfers
6 transfer filings in the last year, covering 6 workers. Median labor-condition decision: 7 days. An employer that already files transfers is one that can take over an existing H-1B.
Sourced from Department of Labor LCA, PERM and prevailing-wage disclosure data. Employer matching is by name, so figures may be split across an employer's legal entities. Absence of a filing means none appears in our copy of the data, not that none exists.
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About the role
- Reliability & Observability - Dashboards and alerting for database performance, cache hit rates, connection pool utilization, API latency by customer.
- Strong backend fundamentals in Python, Go, TypeScript, or similar
Responsibilities
- Rate Limiting - Design systems that respect EHR API rate limits while maintaining user experience.
- Operate with real ownership and accountability in an environment where there are no bystanders: If something is broken, we fix it! You will have meaningful autonomy and be expected to drive work to completion.
- Rate Limiting - Design systems that respect EHR API rate limits while maintaining user experience. Build infrastructure that degrades gracefully under load: queue management, circuit breakers, load shedding.
- We operate as a championship team, and that means being ok with hard, uncomfortable, ambiguous problems that lead to real greatness.
- You will have meaningful autonomy and be expected to drive work to completion.
Requirements
- 7+ years in software engineering, 3+ focused on infrastructure, backend systems, or platform engineering
- Comfort reading code across the stack to trace performance issues
- Track record of diagnosing and solving scaling or reliability problems
Nice to have
- Deep experience with relational databases (Postgres preferred)
Skills
- Database Architecture & Scaling -
Compensation
- 401(k) with a company match of up to 3% of base salary
- Flexible time off with no annual cap, company-wide holidays and an annual holiday shutdown from December 24-January 1 designed to support real rest and long-term sustainability.
- Annual company-wide off-sites, team off-sites and regular team lunches and all-hands gatherings, with travel, lodging and meals covered
Benefits
- Work on mission-critical AI technology that directly improves clinicians' day-to-day lives and health system financial health across some of the most complex, high-stakes workflows in the world.
- To help you do your best work, we pair these expectations with benefits intentionally designed to help you feel supported and safe at Ambience and beyond.
- Some of our key benefits include
- Comprehensive medical, dental, and vision coverage for you and your dependents
- Parental leave to support your family needs
- Flexible time off with no annual cap, company-wide holidays and an annual holiday shutdown from December 24-January 1 designed to support real rest and long-term sustainability.
- Ambience Healthcare is an
Company info
- Here at Ambience, we never set out to be just another scribe. We're building the AI intelligence platform that restores humanity to healthcare and drives meaningful ROI for health systems across the country.
- Our technology helps providers focus on delivering great care by removing the administrative burden that pulls them away from patients and away from their most impactful work. Ambience delivers real-time coding-aware documentation and clinical workflow support across ambulatory, emergency and inpatient settings at the top health systems in North America.
- Our teams operate relentlessly with extreme ownership to build the best solutions for our health system partners. We value candor, positivity and deep thought - and we expect a lot from each other because we know the problems we're solving truly matter.
- Ambience was ranked #1 for Improving the Clinician Experience in the KLAS Research Emerging Solutions Top 20 Report, recognized by Fast Company as one of the Next Big Things in Tech, named one of the best AI companies in healthcare by Inc., and selected as a LinkedIn Top Startup in 2024 and 2025. We're backed by Oak HC/FT, Andreessen Horowitz (a16z), OpenAI Startup Fund, and Kleiner Perkins - and we're just getting started.
- Here at Ambience, we never set out to be just another scribe.
- We're building the AI intelligence platform that restores humanity to healthcare and drives meaningful ROI for health systems across the country.
- Our technology helps providers focus on delivering great care by removing the administrative burden that pulls them away from patients and away from their most impactful work.
- Ambience delivers real-time coding-aware documentation and clinical workflow support across ambulatory, emergency and inpatient settings at the top health systems in North America.
- Our teams operate relentlessly with extreme ownership to build the best solutions for our health system partners.
- We value candor, positivity and deep thought - and we expect a lot from each other because we know the problems we're solving truly matter.
- Ambience was ranked #1 for Improving the Clinician Experience in the KLAS Research Emerging Solutions Top 20 Report, recognized by Fast Company as one of the Next Big Things in Tech, named one of the best AI companies in healthcare by Inc., and selected as a LinkedIn Top Startup in 2024 and 2025.
- We're backed by Oak HC/FT, Andreessen Horowitz (a16z), OpenAI Startup Fund, and Kleiner Perkins - and we're just getting started.
- Ambience processes millions of patient encounters across the nation's largest health systems.
- These organizations trust us with real-time clinical workflows where latency and reliability directly impact patient care.
Equal opportunity
- equal opportunity employer and is committed to building a diverse and inclusive workplace.
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This listing is sourced directly from Ambience Healthcare's careers page and normalized into a canonical job model.