Senior Backend Engineer II - Patient

At Prenuvo, we are on a mission to flip the paradigm from reactive “sick-care” to proactive health care. Our award-winning whole body scan is fast (under 1 hour), safe (MRI has no ionizing radiation), and non-invasive (no contrast). Our unique integrated stack of optimized hardware, software, and increasingly AI, coupled with the patient-centric experience across our domestic and global clinics, have allowed us to lead the change against “we caught it too late again”.

We're looking for a Senior Backend Engineer II to join our Patient Experience team and own the communications platform that keeps patients informed throughout their journey: booking confirmations, appointment reminders, intake nudges, results notifications, and follow-ups across email, SMS, and push. You'll also build on the patient-facing APIs behind our patient dashboard (web) and native mobile apps (iOS and Android).

Our in-house Python communications service converts event bus domain events into patient messaging via Iterable, AWS SES, SMS, and push. Key challenges involve ensuring reliable, exactly-once delivery, respecting consent and preferences, and gracefully handling vendor failures with detailed logging. We seek engineers who thrive on end-to-end system ownership, resilient event-driven architecture, and driving outcomes over tickets.

Our preference is for candidates based in Vancouver, who can accommodate a flexible hybrid arrangement during the initial onboarding period.

This role does not provide visa sponsorship. Applicants must be legally authorized to work in Canada at the time of hire and must not require employer sponsorship for a work visa (current or future).

Help reshape the world through proactive healthcare while working with cutting-edge technology and high performing teams with deep expertise - join us to make a difference in people’s lives!

• Own the communications platform: Own the patient communications platform end to end, from design through rollout, including service architecture, on-call standards, and technical roadmap.
• Develop complex software solutions: Build and maintain scalable backend services using Python, FastAPI, and AWS event-driven services (Event Bridge, SQS/SNS, Lambda, ECS) that power patient communications.
• Deliver reliably: Guarantee reliable, exactly-once message delivery through retries and failures, using idempotency, deduplication, backoff, and dead-letter handling and replay, with a clear status for every message we attempt.
• Build in consent: Build consent and preference handling into the send path, including channel and category opt-ins, STOP and unsubscribe propagation across systems, quiet hours, and clean separation of transactional and marketing messages.
• Make sends safe: Build safe tooling for one-off and bulk patient sends (audience preview, test sends, rate limits, kill switches) with least-privilege access to patient data and vendor credentials, so that a production send is always a deliberate, reviewed action.
• Evolve patient-facing APIs: Design and ship OpenAPI-first endpoints that follow our versioning and backward-compatibility standards for mobile clients we can't force-update, and help migrate consumers off legacy GraphQL.
• Ensure system reliability: Lead improvements in reliability, observability, and incident response using Datadog. You are accountable for whether a message actually reached the patient, not just whether the code merged.
• Raise engineering quality: Write comprehensive automated tests for the services you build, and improve the patterns, tooling, and processes that raise quality across teams.
• Provide technical guidance: Lead design discussions, review technical implementations, and mentor engineers across levels.
• Influence…