Staff Engineer, Backend & Data

Staff Engineer Opportunity at Trial Library

Trial Library is an AI-native enrollment and care navigation platform that accelerates access to precision medicine. In collaboration with biopharmaceutical manufacturers, payers, and health systems, Trial Library enables the delivery of clinical trials as a standard care option - improving patient access, advancing oncology outcomes, and reducing the total cost of care. Backed by leading healthcare venture capital firms, Trial Library's platform is currently deployed in 840+ clinics and 3,000+ providers nationwide.

We're hiring a second Staff Engineer to own key parts of our backend and data platform. Our platform supports our teams that identify eligible patients for clinical trials and navigate patients around any barriers to enrolling in a trial. You will take technical leadership of our most critical systems as we navigate a massive architectural shift that will be a step-change in our ability to refer patients to trials: moving from narrow, human-assisted data pulls to robust, automated integrations with EMR systems to ingest complete patient records.

If cloud-native architecture, building AI agents to empower our human experts, exploring non-deterministic approaches to patient-trial matching, and handling HIPAA-grade data sounds like the right problem space, please keep reading.

Our engineering culture values direct communication, strong ownership, and low-ego collaboration. We laugh a lot and use a ton of Slack emojis. We make decisions quickly, give open feedback, and we have a strong bias toward action.

Your Responsibilities

• You will own the systems that power Trial Library's core workflows and be accountable for their reliability, evolution, and scale.
• A meaningful part of that is designing for reliability in compute-intensive, long-running workflows: the kind of problems where serial processing breaks under load, timeouts become production incidents, and the right architecture (async pipelines, message queues, container-based compute) is what separates a working feature from a failing one.
• You will independently monitor production, triage issues quickly, and maintain a close read on how our platform is actually experienced by the clinicians, coordinators, and partners who depend on it.
• Beyond technical ownership, you will shape how good engineering gets done at Trial Library. As AI coding tools and improved models change what's possible and how the whole team works, this role calls for someone who will continuously rethink what engineering excellence actually looks like.
• You keep a close pulse on how AI is changing software development, evaluate emerging practices critically, and champion the approaches that make sense for our organization. These best practices may include standards for how code reviews are done, how tests get written, what shared conventions need to exist, and where human judgment is most needed. You'll mentor engineers and set development standards that stay relevant as the tools underneath all of us keep evolving.

Your Qualifications

• Deep AWS experience (Lambda, Fargate, SQS, RDS, and the surrounding ecosystem) and the ability to choose the right service for the right job
• Proven track record of leveraging AI coding tools creatively and effectively to build production systems.
• Demonstrated ability to take autonomous ownership, identifying and resolving systemic issues independently.
• Startup experience, where you have built from scratch at an early-stage company and treated ambiguity as an opportunity rather than an obstacle
• Strong systems thinking, encompassing backend architecture, APIs, databases, and scalability under real-world constraints.
• Clear communication and influence, with the ability to explain tradeoffs to both engineers and non-engineers to earn trust through honesty
• Healthcare alignment with a genuine interest in improving clinical trial access and health equity; HIPAA experience a strong plus

$168,000 - $230,000 a year Compensation & On-Site Requirement This is a hybrid role based in San Francisco, CA, with a requirement of three days per week in the office;
Wednesday, Thursday, and Friday. The salary range for this position is $168,000–$230,000 per year and reflects a good faith estimate of base pay for candidates working in this location. Final compensation will be based on experience, skills, and qualifications.