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Salary: USD 230,000 - 280,000 / annual
Qualified Health is building generative AI infrastructure for healthcare, providing guardrails for safe AI governance, healthcare-specific agent creation, and real-time algorithm monitoring. We're seeking a Principal Backend Engineer to shape the technical direction and architecture of our AI-powered healthcare SaaS platform.
As one of the most senior individual contributors on the engineering team, you will lead the design and evolution of critical backend systems, solve complex technical challenges, and establish engineering foundations that enable reliable and secure scaling. You'll work closely with engineering, product, AI, and security leadership to translate business priorities into long-term technical strategy and drive high-impact initiatives across teams.
Key responsibilities include:
- Defining and driving long-term technical direction for core backend systems and services, establishing architectural principles that enable scalability, security, reliability, and sustainable growth
- Identifying and leading complex engineering initiatives spanning multiple teams, building alignment around technical priorities, and resolving architectural disagreements
- Designing, implementing, and reviewing critical backend infrastructure components while fostering an AI-first culture
- Architecting resilient distributed systems, APIs, data services, and asynchronous workflows to support enterprise workloads and complex integrations
- Establishing engineering practices that improve system reliability, observability, performance, and operational efficiency
- Mentoring Senior and Staff engineers, developing emerging technical leaders, and fostering a culture of technical rigor and collaboration
- Collaborating with leadership to evaluate technical investments, make build-versus-buy decisions, and balance near-term delivery with long-term platform sustainability
This is a hands-on technical leadership role where you'll work directly on the hardest engineering problems while multiplying the impact of engineers around you and raising engineering standards.
REQUIREMENTS:
- Demonstrated track record of architecting, building, and operating complex, large-scale backend or platform systems in production with measurable technical and business impact
- Deep expertise in distributed systems, including service architecture, data consistency, concurrency, fault tolerance, scalability, and performance optimization
- Expert-level proficiency in at least one modern backend programming language, with ability and willingness to work extensively in Python
- Strong experience designing and operating cloud-native applications on AWS, GCP, or Azure, with understanding of infrastructure automation, deployment practices, and production operations
- Deep understanding of API design, data modeling, databases, asynchronous processing, and modern backend architectural patterns
- Ability to navigate ambiguity, independently identify important technical problems, and translate complex requirements into pragmatic, scalable solutions
- Demonstrated ability to improve engineering effectiveness through architectural simplification, reusable systems, mentorship, and technical standards
- Ability to work on-site in Palo Alto office three days per week
DESIRABLE QUALIFICATIONS:
- Experience designing, building, or operating production generative AI applications, LLM-powered workflows, or AI infrastructure
- Experience building multi-tenant enterprise SaaS platforms with strong requirements for security, isolation, scalability, and availability
- Experience with Google Cloud Platform, Kubernetes, Terraform, and modern monitoring and observability tooling
- Experience building systems in regulated environments (healthcare, financial services, etc.) with stringent data privacy and security requirements
- Familiarity with HIPAA, SOC 2, or comparable security and compliance frameworks
- Experience establishing technical foundations, engineering standards, and architectural direction in rapidly growing organizations
