Senior Full-Stack Engineer — Backend-Focused
Remote · Platform Engineering · Full-time · 4–5 years experience
About the Role
We're a healthcare technology company building a multi-tenant case-management platform that orchestrates
complex clinical, payment, and communication workflows. You'll build backend services that power the product
— a TypeScript GraphQL API on Node.js, backed by PostgreSQL/Prisma and deployed on Google Cloud,
integrating a broad ecosystem of third-party healthcare, payment, and communication providers.
This is a senior, high-ownership role on a remote-first team. You'll design systems, lead complex integrations,
mentor engineers, and influence our architecture as we scale.
What You'll Do
• Design, build, and operate backend features on our Node.js + TypeScript platform using Express + Apollo
GraphQL in a modular-monolith architecture.
• Model and evolve a large, multi-tenant data layer with Prisma 7 on PostgreSQL (including read replicas),
with attention to performance, indexing, and data integrity.
• Build and harden third-party integrations — payments (Stripe, NMI), communications (SendGrid, Twilio),
CRM (HubSpot), scheduling (Calendly), and healthcare systems (Dosespot, pharmacy/consult-provider
APIs).
• Design event-driven and asynchronous workflows using Google Cloud Pub/Sub, scheduled jobs (App
Engine Cron), and Cloud Functions — for payment retries, follow-ups, escalations, and batch processing.
• Implement secure authentication and RBAC (Firebase Admin, JWT, OTP flows, granular permissions) in a
multi-tenant, compliance-sensitive context.
• Work with GCP services — App Engine, Cloud Storage, BigQuery, Document AI, Secret Manager — and
contribute to CI/CD via GitHub Actions and Prisma migration pipelines.
• Make full-stack changes when needed — wiring up the Vue 3 / Apollo frontend to ship a feature completely.
• Write robust tests with Vitest + Supertest and Firebase emulators; ensure reliability, observability
(Winston/Cloud Logging), and safe rollouts.
• Mentor engineers, lead design discussions, and own systems end-to-end in production.
What We're Looking For
• 4–5 years of professional backend or full-stack engineering experience, with a track record on
medium-to-large-scale production systems.
• Strong Node.js + TypeScript expertise and solid API design skills (GraphQL strongly preferred; strong
REST background welcome).
• Deep relational database experience — schema design, query optimization, migrations — ideally with
Prisma/PostgreSQL or comparable ORMs.
• Experience building and maintaining complex third-party integrations and webhook-driven systems,
including payments.
• Familiarity with cloud infrastructure (GCP preferred; AWS/Azure transferable), async messaging/queues,
caching (Redis), and CI/CD.
• Solid grasp of authentication, authorization (RBAC), and security best practices.
• Enough frontend competence to contribute to a Vue/React + GraphQL client when a feature demands it.
• Demonstrated ability to own systems independently, take responsibility for reliability and on-call quality,
and reason about scale and trade-offs.
• Excellent written and verbal communication — essential for our remote, async culture.
• Leadership qualities: you mentor others, drive technical design, and raise engineering standards.
Nice to Have
• Experience with Pub/Sub, BigQuery, Document AI, or other GCP-native services.
• Background in healthcare, fintech, or regulated/compliance-sensitive domains (HIPAA awareness a plus).
• Experience with multi-tenant SaaS architecture and data isolation.
• Familiarity with AI/LLM integrations (Claude, OpenAI, vector DBs like Pinecone).
• Experience scaling systems with rate limiting, observability, and performance tuning.