Staff Backend Engineer

We’re Heidi We're building the future of healthcare by giving every clinician the earth's finest AI Care Partner. Our platform has absorbed the administrative chaos of 175 million patient visits and supported 67 million clinical hours. Today, we support 2.8 million patient sessions a week across 190+ countries, in 110 languages and over 200 specialties. Healthcare systems are failing us; clinicians spend more time on documentation than on patients, and the human connection that makes medicine worth practicing is eroding. Our mission is simple: double the world’s capacity for care and strengthen the human connection at its heart. We found product-market fit with a freemium medical scribe that clinicians love. Now, we're expanding. Every task a clinician hands to Heidi is a patient who feels more attended to, a health system unclogged, and a clinician who gets to be a clinician again. We’ve grown annual recurring revenue from $1 million to $50 million in two years. To go further, we’ve secured US$340 million: a $100 million Series C led by Blackbird, with Phoenix Court, Point72 Private Investments and Headline, alongside a $240 million growth investment led by General Catalyst’s Customer Value Fund. If you want to join us in doing work worth shipping, jump in. What You’ll Do Own backend architecture. Define service boundaries, data ownership and interface contracts across our Python codebase, and make the calls about what becomes a service, what stays a module and what gets merged back.Run the design process, not just the designs. Write and review design docs, set the bar for what a proposal needs before it gets built, and give engineers architectural feedback early enough to matter.Build the paved road for backend development: service templates, shared libraries, migration tooling, test harnesses, CI pipelines and a local dev setup that works on the first try. Make the right way to build a service the fastest way.Set and maintain backend code standards around structure, typing, testing, error handling and observability, then encode them in tooling so they hold without anyone policing them.Take on the refactors nobody else can. Untangle the modules that every team is afraid to touch, and land them incrementally without freezing product work.Keep a live view of code and system health: test coverage where it counts, build and deploy times, flaky tests, dependency drift, latency budgets, the slow database queries that will hurt in six months.Balance delivering new product surface against paying down the debt worth paying, and be straight with the team about which one a given quarter needs.Drive collaboration across teams, working with product managers, clinicians, frontend engineers and infrastructure so that architecture decisions hold up against how the product actually gets used.Provide technical leadership and mentorship to backend engineers, championing best practices and lifting the standard of what the team considers normal.Deepdive into weird edge cases and solve hard and tiny problems for our users. What We’re Looking For 8+ years of professional backend engineering experience, with deep expertise in Python and its modern async ecosystem.Advanced proficiency with FastAPI and Django: async request handling, ORM and SQLAlchemy patterns, background workers and task queues, versioned API design, and zero-downtime migrations.Proven record architecting backend systems at scale, defining module boundaries, establishing patterns, and creating reusable primitives that speed up product development.Experience building paved roads for other engineers. Service scaffolds, shared libraries, internal platform tooling, CI/CD pipelines, and the governance that keeps them from rotting once the person who built them moves on.Demonstrated ability to improve code health on a live codebase: large incremental refactors, deprecation and migration strategy, dependency hygiene, static analysis and type coverage as tools rather than rituals.Strong distributed systems grounding, including idempotency, retries and backpressure, caching strategy, event-driven patterns, and graceful degradation under load.Deep PostgreSQL and NoSQL knowledge. Schema design, indexing, query tuning, connection management, and safely changing large live tables. zT TStrong experience in a monorepo environment, including shared packages, build pipelines, versioning and cross-team collaboration.Strong grounding in modern testing practices, including Test-Driven Development (TDD), Behavior-Driven Development (BDD), pytest, contract testing, integration testing and load testing.Fluency with observability tooling such as Datadog: distributed tracing, structured logging, useful dashboards, and alerts people trust rather than mute.Comfort working with PHI under HIPAA and equivalent regimes, designing for auditability, least privilege and data residency from the start.Experience using AI-assisted coding tools (for example GitHub Copilot, Claude, Codex) to improve productivity, code quality and architectural exploration.A focus on fast, high-quality delivery, balancing pragmatic execution with strong testing, observability, performance and security standards.Natural technical leadership, including mentoring senior engineers, defining technical strategy, driving architectural decisions and improving team-wide engineering practices.Excellent collaboration and communication skills, especially the writing. Much of this role lands as design docs, review comments and standards other engineers will follow. How We Show Up Build for the next decade, not next quarter. Our targets are outrageous on purpose. The world's health doesn't have the luxury of incrementalism.Lead, don't wait. We treat tomorrow's problems today. Sometimes we build what's needed before it's wanted, and we're fine with that.Follow the evidence. Trust the patient. We pursue truth relentlessly. But when the subjective and objective disagree, we treat the patient, not the numbers. Ego is a comorbidity we can't afford.Own the outcome. Everyone here carries the company. Raise problems with solutions, solve them end-to-end, and never be a bystander.Ship, measure, go again. A button today, a workflow tomorrow. More iterations beat better planning. We're precise at pace, not reckless.Live in clinicians' reality. Not the ideal workflow, the twenty-patients-before-lunch actual one. We build for exhausted humans, and we'd better be decent ones while we do it. Why Heidi? You’ll join a team measured on real-world impact, not press cycles. We live and breathe the challenges of modern health systems, and are laser-focused on exacting the change we’d like to see. We’re medicos, engineers, builders and designers who’ve felt (on every side of the equation) what non-care feels like, the moral and practical toll as a provider or receiver. Building what we’re building isn’t always easy. Standard tech playbooks routinely fail in healthcare, and the friction of the medical system will test your perseverance. But we didn’t choose easy, we chose a purpose-driven mission that actually matters. We hold ourselves to a higher standard because healthcare demands it. If you join Heidi, you recognize that the deeper question isn’t whether AI can solve the global healthcare crisis, but whose hands will shape it. True A-players progress extremely fast here. The nature of the scale-up game is demanding, but we value sustainable performance and mental health. You're trusted to perform, and you set your schedule. We operate on outcomes > inputs, not process theatre. We all take the bins out, metaphorically and literally. We take care of you. We offer a $1,000 annual learning and development budget, a $150/month health and wellness allowance, a $500 home office budget, 26 weeks paid primary parental leave and 18 weeks paid secondary parental leave, fertility support up to $10,000, four weeks of work from anywhere per year, and serious equity.