Senior Backend Engineer, Application Platform

Description

The company builds AI agents that run specialty pharmacy operations from end to end, covering prescription reading and validation, phone calls, and movement through eligibility and fulfillment.

Specialty pharmacy still relies on faxes, phone calls, and manual data entry, and patients can wait weeks for expensive therapies. The company is already in production and processes tens of thousands of prescriptions a week.

The company is backed by Gradient Ventures, Google's AI fund. Its founders previously worked at Apple's Applied ML group, Included Health, and Avella Specialty Pharmacy, which grew to over $1.5B before OptumRx acquired it.

Every pharmacy uses the same core objects (prescriptions, directions, insurance claims, rejects) but handles them slightly differently, so each new customer currently needs custom code. The goal is to make setup a matter of configuration, carried out by a technical solutions team with internal tools and no engineer involved.

The role is a backend problem with real stakes. You will model the shared objects so one system can handle each pharmacy's differences, build the configuration layer and the backend behind the tools, and define the interface between the engine and the people who tune it. This includes how new versions reach only the customers who opt in, on a live system that cannot break.

You would own the application platform, including its domain model, configuration layer, and tooling, and work directly with the founders and early engineering team on architecture and direction.

Responsibilities

• Model the core objects (prescriptions, directions, insurance outcomes) and build a backend that expresses each pharmacy's differences as configuration, so a single system serves many pharmacies.
• Determine what a solutions team can safely configure and what must remain in the engine.
• Build the backend services and APIs behind the internal tools that let a solutions team onboard a new customer without engineering help.
• Design and version the interface between the engines and those who configure them, so upgrades roll out safely and selectively.
• Deploy changes to a live system where a bad migration delays a patient's therapy, so zero-downtime releases and careful versioning are required.
• Work with the founders and early engineering team on architecture and roadmap.

Requirements

• You have 5+ years of experience building production backend systems.
• You can take an open-ended problem, design a coherent system for it, and clearly explain the trade-offs.
• You model data and design APIs well and build general solutions rather than one-off fixes.
• You have built a configuration-driven system that others operated, such as a rules engine, multi-tenant platform, feature-flag or rollout system, or workflow DSL, and you understand the common ways these fail.
• You have built a product from zero to one at a startup and are comfortable working without clear answers.
• You will spend time with the solutions team and with pharmacies to learn how their workflows differ. Healthcare experience is not required.

Conditions

The company is a small team of a handful of people focused on one problem. The work is intense, holds a high bar, and ships to real patients, so it suits some people more than others.

Equal opportunity applies.