Founding Engineer, Backend & Infra

We are looking for a Founding Backend Engineer with 3+ years of experience to own and scale the core distributed systems that power Backbone's clinical AI platform for healthcare payments. You'll be the engineer responsible for building the full backend infrastructure — from chart ingestion and claims processing to browser-use automation and payer portal navigation — handling hundreds of thousands of pages of messy healthcare data at scale. This is a role for a systems thinker who has owned meaningful engineering scope at a company known for exceptional engineering, and who can design and implement complex backend architecture end-to-end without handholding. You'll work directly with the founding team to build the infrastructure layer that the entire product sits on top of.

What will you be doing?

Build and scale the distributed backend systems powering Backbone's clinical and financial workflows — including chart data processing, claims workflows, authorization and denial pipelines, and payer/provider integrations

Own browser-use and computer-use systems that navigate complex medical record software and payer portals

Design reliable infrastructure for incredibly messy healthcare data: scanned charts, PDFs, structured claims, unstructured notes, and operational state at massive volume

Build orchestration, queuing, retry, and observability infrastructure for long-running, failure-prone workflows across EHRs, clearinghouses, and payer systems

Work with research and product engineers to take new clinical intelligence capabilities into production, setting the engineering patterns future engineers will inherit