Principal Software Engineer
AI-native healthcare workflow company, NYC
About the role
The platform ingests high volumes of clinical documents and events, so the backend has to be reliable under load and easy to extend as new integrations come in. The CTO wanted a principal-level engineer who could set long-term architecture direction and still ship: someone who has personally owned large-scale backend systems, can break a growing monolith into services without slowing the product team down, and treats AI as a feature of the system rather than the center of the job.
What the role owned
- Backend architecture and the long-term evolution of the platform, including the path from monolith to services.
- High-volume document and event processing: queues, retries, idempotency, and observability.
- Integration-heavy systems across EHR, fax, and partner data feeds.
- Technical direction and mentorship across the engineering team.
What the client was looking for
- Repeatedly built and owned business-critical backend systems at high-growth SaaS or healthtech companies.
- Deep systems design judgment and the ability to explain tradeoffs and failures, not just wins.
- Still hands-on and comfortable in a live system design and coding loop.
- Pragmatic, product-minded, and comfortable in ambiguity.
Nice to have
- Healthcare integrations (EHR, FHIR, HL7), OCR, or document pipelines.
- Founding or early engineering experience at a Series A to C startup.
How the search ran
Confidential search worked directly with the CTO. Four submitted, three finalists, closed in 34 days.
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