Senior Backend Engineer

Location: New York

Who is Recruiting from Scratch:

Recruiting from Scratch is a talent firm that focuses on placing the best candidate for our clients.https:///

Senior Backend Engineer - AI-Driven Healthcare Systems

Location:

San Francisco, CA or Austin, TX
Company Stage of Funding: YC-Backed Startup
Office Type:
Hybrid (In-person collaboration required)
Salary: $110,000 - $180,000 with equity (.2% - .6%)

Company Description

Our client is revolutionizing the telepsychiatry industry by embedding AI technology into everyday operational workflows. This innovative YC-backed startup is not just building another diagnostic tool – they're creating a comprehensive platform where operational AI powers every aspect of patient care, from scheduling and billing to provider workflows.

With solid early traction and ambitious growth plans, our client aims to become a $1B+ company by serving hundreds of thousands of patients across all 50 states through the most efficient verticalized healthcare engine ever built. Their culture encourages excellence, resourcefulness, and excitement for working on meaningful healthcare problems with a dedicated team.

What You Will Do

• Architect & Scale Mission-Critical Systems:
Design and implement a highly scalable, event-driven backend using Node.js, Supabase (Postgre

SQL), and AWS while optimizing for real-time data processing

• Build AI-Powered Workflows:
Develop systems that integrate LLM-powered automation for intake processing, scheduling optimization, and automated billing validation

• Design Event-Driven Architecture:
Create robust event pipelines for capturing and processing structured operational data using technologies like Kafka or RabbitMQ

• Maintain Security & Compliance:
Implement HIPAA-compliant systems for handling patient health information with the highest standards of data integrity and security

Ideal Candidate Background

• 5+ years of experience in backend development

• Strong expertise in Node.js, Type Script, and PostgreSQL

• Experience with event-driven architectures (Kafka, Rabbit

MQ, event sourcing)

• Demonstrated success building real-time data processing systems

• Comfort working with AI/LLM systems (deep AI expertise not required)

• Track record of building systems that scale efficiently to handle growing user bases

• Security-first mindset with experience in regulated environments (HIPAA experience is a plus)

Preferred Qualifications

• Experience with Postgre

SQL/Supabase for high-performance data management

• Background in containerization (Docker, Kubernetes)

• Experience working in fast-paced startup environments

• Previous work at companies focused on event-processing or database technologies

• Genuine interest in healthcare transformation

Compensation and Benefits

• Competitive salary range: $110,000 - $180,000 based on experience

• Equity compensation: .2% - .6% (adjusted based on salary)

• Comprehensive health insurance

• Opportunity to make a meaningful impact in mental healthcare

• Work with a dedicated team on cutting-edge technology

• 30 months of runway for sustainable growth

This is an extraordinary opportunity to join a mission-driven company that's using technology to transform mental healthcare delivery. As a Senior Backend Engineer, you'll be at the intersection of AI and healthcare operations, directly contributing to faster, more efficient care for patients nationwide. Your work will help build the foundation for a system that improves lives while offering significant professional growth as the company scales.

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