Senior Engineer, Backend Architecture

Position Overview

• Location Type: Remote (United States)
• Job Type: Full-time
• Salary: $180,000 - $200,000 per year plus equity & company bonus, benefits

Healthie powers virtual-first care delivery, improving access to healthcare and enabling better patient outcomes through technology. We build essential infrastructure for virtual-first care, including EHR, scheduling, and patient engagement solutions. Our API-first approach allows organizations of all sizes to build, customize, and scale their businesses. We currently support thousands of organizations, from small practices to large healthcare companies, enabling them to deliver care to millions of patients across various health services. We believe the future of healthcare is virtual-first, longitudinal, and collaborative.

About the Role

Healthie is seeking a Sr. Engineer to join our Backend Architecture team. This team is responsible for developing the foundational systems that support our backend services. In this role, you will help define architectural patterns, shared libraries, and data modeling strategies to ensure backend teams can move fast, scale safely, and build consistently. You will collaborate with engineers across Product & Engineering to design and build scalable, resilient, and maintainable systems. Your initial focus will be on supporting horizontal scaling and enhancing data migration infrastructure. This is a hands-on role for individuals who enjoy optimizing legacy code, scaling large monoliths, and establishing the technical foundation for our backend's future. Beyond coding, you will be a strategic contributor, identifying technical investment areas, mentoring engineers, and helping Healthie scale its technology and culture. Your work will directly impact healthcare organizations' ability to deliver better, more efficient care.

Requirements

• 6+ years of backend engineering experience
• Deep expertise with Ruby on Rails
• Proven experience designing scalable backend systems in complex monolithic or hybrid architectures
• Hands-on knowledge of horizontal database scaling, schema evolution, and high-scale data operations
• Experience building internal frameworks, utilities, and shared services to improve developer velocity
• Comfortability navigating and incrementally improving legacy systems with minimal risk
• Strong communication skills and a collaborative mindset
• Mission-driven, passionate about healthcare, and motivated to build impactful infrastructure

Responsibilities

• Design and evolve core architectural patterns for backend services, data modeling, and async workflows
• Lead backend scalability initiatives, including database sharding and large-scale data migrations
• Build and maintain shared libraries and frameworks (e.g., for jobs, retry logic, audit logging)
• Partner with product and platform teams to guide system design and service boundaries
• Review technical designs from across the organization, ensuring long-term scalability and maintainability
• Drive performance tuning efforts (e.g., indexing, query optimization, load resilience)
• Mentor engineers and act as a steward for backend architectural consistency across teams
• Contribute to infrastructure related to observability, data governance, and eventing

Company Information

• Mission: Healthie powers virtual-first care delivery, improving access to healthcare and enabling better patient outcomes through technology.
• Learn more at: https://www.gethealthie.com/

Application Instructions

• U.S. work authorization is required.
• Healthie does not provide sponsorship.