Founding Engineer, Backend & Infra (US)

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 work hand-in-hand with the CEO & founding team (ex-Meta, Google & Stanford AI) to own 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.

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