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Salary: CAD 145,000 - 160,000 / annual
Prenuvo is transforming healthcare from reactive sick-care to proactive health care through award-winning whole-body MRI scans (fast, safe, non-invasive) combined with AI and patient-centric clinic experiences.
You will join the Patient Experience team as Senior Backend Engineer II, owning the end-to-end communications platform that keeps patients informed throughout their journey: booking confirmations, appointment reminders, intake nudges, results notifications, and follow-ups across email, SMS, and push channels. You'll also build and evolve patient-facing APIs powering the patient dashboard (web) and native mobile apps (iOS and Android).
Key responsibilities include:
- Own the communications platform end-to-end: architecture, on-call standards, technical roadmap, and rollout
- Build and maintain scalable backend services using Python, FastAPI, and AWS event-driven services (EventBridge, SQS/SNS, Lambda, ECS)
- Guarantee reliable, exactly-once message delivery through idempotency, deduplication, retries, backoff, dead-letter handling, and replay with clear message status tracking
- Implement consent and preference handling: channel/category opt-ins, STOP/unsubscribe propagation, quiet hours, and separation of transactional vs. marketing messages
- Build safe tooling for one-off and bulk sends: audience preview, test sends, rate limits, kill switches, and least-privilege access controls
- Design and ship OpenAPI-first patient-facing endpoints following versioning and backward-compatibility standards for mobile clients, and help migrate consumers off legacy GraphQL
- Lead reliability, observability, and incident response improvements using Datadog; own accountability for whether messages actually reach patients
- Write comprehensive automated tests and improve patterns, tooling, and processes to raise quality across teams
- Lead design discussions, review technical implementations, and mentor engineers across levels
- Contribute to architectural decisions and long-term platform evolution, partnering with Product, Design, Lifecycle Marketing, Clinical, and other engineering teams
- Use AI coding tools and agentic workflows thoughtfully as part of structured build, review, and test workflows
The in-house Python communications service converts event-bus domain events into patient messaging via Iterable, AWS SES, SMS, and push. Key challenges involve ensuring reliable delivery, respecting consent and preferences, and gracefully handling vendor failures with detailed logging.
Preference is for candidates based in Vancouver who can accommodate a flexible hybrid arrangement during initial onboarding. This role does not provide visa sponsorship; applicants must be legally authorized to work in Canada and must not require employer sponsorship.
Qualifications:
- 7+ years of backend engineering experience owning production services, ideally in Python (or similar: Ruby, Go, Node.js)
- Strong experience designing and building REST APIs: contract design, versioning, error handling in modern frameworks (FastAPI, Flask, Django, Express, Spring)
- Hands-on experience with AWS cloud platforms, including event-driven systems (EventBridge, SQS/SNS, Lambda, ECS) and modern CI/CD practices
- Experience building and maintaining distributed systems, integrating external APIs and webhooks, with knowledge of idempotency, retries, rate limits, and partial failure handling
- Deep knowledge of relational databases (particularly PostgreSQL) plus experience with NoSQL (e.g., DynamoDB) and caching (e.g., Redis)
- Experience implementing authentication and authorization (OAuth2, JWT, service-to-service security)
- Experience writing comprehensive backend tests (e.g., Pytest) with strong test coverage
- Experience with monitoring and observability tools (Datadog or similar)
- Ability to independently lead complex initiatives, make sound technical decisions, balance short-term delivery with long-term maintainability, and handle on-call/incident response
- Ability to break down complex projects into components or milestones for other engineers
- Comfortable with ambiguity, able to balance speed with quality, willing to own from design through production
- Excellent communication and cross-functional collaboration skills
Nice to have:
- Experience with Iterable or similar customer engagement platforms (Braze, Customer.io, Klaviyo, Salesforce Marketing Cloud)
- SMS experience at scale (Twilio or similar): 10DLC, short codes, opt-in capture, STOP handling, TCPA/carrier compliance
- Push notification experience (APNs, FCM, device token lifecycle, deep linking)
- Email delivery experience (AWS SES or similar, SPF/DKIM/DMARC, bounce/complaint handling, suppression lists)
- Notification orchestration: multi-channel routing, preference centers, frequency capping, scheduled/reminder messaging
- GraphQL experience, Backend-for-Frontend patterns, or close partnership with native iOS/Android teams
- Familiarity with FHIR or healthcare data models
- Familiarity with Terraform, Docker, GitHub Actions
- Experience in highly regulated industries handling sensitive health data
