Are you the engineer who makes every other engineer faster?
Most infrastructure roles put you in a silo. Write Terraform. Maintain pipelines. Stay in your lane. This one is different. You'll write production backend code AND own the infrastructure it runs on. If you've been looking for a role where "backend" and "infra" aren't separate disciplines, keep reading.
A rapidly scaling AI healthcare startup is hiring a Backend Infrastructure Engineer to own the critical layer between application code and cloud infrastructure. The company raised $35M from a16z, Google Ventures, and Pear VC. Founded in 2023, they already serve over 100,000 patients on their platform and are on track to reach hundreds of thousands within the next year. The founding team brings deep medical and technical pedigree across Harvard, Mass General, UCSF, MIT, Google DeepMind, NVIDIA, and Stripe.
Their product works. Physicians using the platform resolve 96% of patient issues with 2-minute response times. Your job is to make the systems underneath it scale reliably while keeping a fast-growing engineering team productive.
What your day-to-day looks like:
You'll develop and maintain cloud infrastructure using Terraform across AWS and GCP. You'll own CI/CD pipelines end-to-end with one goal: make production deploys boring. Fast, reliable, automatic. You'll write production backend services in TypeScript and Node.js, contributing real application code to core server-side systems. You'll build the foundational archetypes (abstract base stream consumers, cron executors, worker patterns) that the rest of the team builds on top of. You'll improve local dev workflows, reduce build times, eliminate flaky infrastructure, and build internal tooling the team wants to use. And you'll do all of this inside a HIPAA-regulated healthcare environment, working closely with security and compliance on secrets management, IAM policies, network isolation, and audit logging.
What you'll bring:
3-5 years in backend engineering, infrastructure engineering, or a hybrid of both
Strong proficiency in a strongly-typed or compiled language (Go, Rust, Java, TypeScript)
AWS/GCP/Azure experience and comfort with Docker and containerised environments
A bias toward automation. If you do something manually twice, you're already writing the script
Kubernetes experience, Terraform, CI/CD pipeline ownership (GitHub Actions, CircleCI), and working in regulated environments (HIPAA, SOC 2) all strengthen your application.
What you'll get:
$180K-$225K base salary + equity in a $35M-funded, a16z-backed company
Comprehensive healthcare, vision, dental, 401K, unlimited PTO, parental leave
Direct interface with leadership and executives at leading healthcare organisations
NYC hybrid, Boston hybrid, or East Coast remote
A team where the right answer wins. Debate is open, egos are low, and the mission is real: multiply the world's healthcare capacity
The tech stack: TypeScript, Node.js, PostgreSQL, Redis, SQS, Temporal, AWS, GCP, Docker, Kubernetes, time-series and vector storage.
This is a role for someone who thinks in systems. You understand how a request flows from a browser through a load balancer, into a container, hits a database, and comes back. And you debug any layer of that stack without blinking.
Interested? You don't need an up-to-date CV at this stage...just apply