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Commure is building an AI Operating System for healthcare that spans the full care journey: Ambient AI and dictation eliminating documentation burden, intelligent agents automating workflows, and autonomous RCM processing billions in claims. The platform is integrated with 60+ EHRs and trusted by 500,000+ clinicians across 500+ healthcare organizations handling $25B+ in annual claims. The company recently raised $70M at a $7B valuation and was named to Fortune's Future 50 list and 2026 AI Breakthrough Awards for "Overall NLP Company of the Year."
You will design, build, and operate backend systems powering the Ambient AI product suite. This involves building inference workflows that coordinate transcription, diarization, language models, clinical extraction, and summarization. Key responsibilities include developing orchestration systems for long-running, multi-stage workflows with scheduling, queueing, retries, idempotency, and safe recovery; improving reliability and scalability under variable, compute-intensive workloads; defining and maintaining SLOs for critical workflows; building strong observability through structured logging, metrics, distributed tracing, and alerting; leading incident response and post-incident analysis; identifying and eliminating systemic failure patterns; improving cloud infrastructure and deployment systems; designing APIs and data models for safe workflow interaction; building tools for pipeline inspection and debugging; balancing reliability, latency, quality, and cost; partnering with mobile, product, AI, security, and clinical teams; and mentoring other engineers on distributed systems and backend architecture.
You will work across audio ingestion, media processing, inference orchestration, distributed workflows, storage, observability, and cloud infrastructure. The role is ideal for an engineer who enjoys making complex systems dependable and understands that infrastructure exists to serve the product—the systems you build must create a fast, reliable, and trustworthy experience for clinicians.
REQUIREMENTS:
- 8+ years of professional backend or infrastructure engineering experience
- Experience designing, building, and operating production distributed systems
- Strong proficiency in at least one modern backend programming language
- Experience with asynchronous processing, message queues, event-driven systems, or durable workflow execution
- Strong understanding of distributed-systems concepts: idempotency, consistency, concurrency, backpressure, retries, failure isolation, eventual completion
- Experience operating services in cloud environments (deployment, monitoring, scaling, incident response)
- Experience designing APIs, service boundaries, and data models for complex product workflows
- Track record of improving system reliability, observability, scalability, or operational efficiency
- Strong debugging skills across application, infrastructure, data, and external dependency boundaries
- Ability to reason about both real-time and long-running workloads with different latency and durability requirements
- Comfort working across backend, infrastructure, product, and AI systems
- Ownership mindset and bias for action
NICE TO HAVES:
- Experience with speech-to-text, diarization, transcription, or audio ML workflows
- Experience orchestrating LLMs or multi-model inference pipelines in production
- Familiarity with workflow orchestration systems (Temporal or similar)
- Experience with event-streaming and messaging (Kafka, Pub/Sub, SQS)
- Experience with model routing, inference gateways, rate limiting, batching, caching, GPU-backed workloads
- Experience building internal tooling for workflow inspection, replay, evaluation, model debugging
- Experience defining SLOs, managing error budgets, designing alerts, leading incident response
- Familiarity with distributed tracing and observability platforms (Grafana, OpenTelemetry, Sentry)
- Experience with containers, Kubernetes, infrastructure as code, cloud-native deployment
- Experience optimizing for throughput, tail latency, infrastructure cost, workload isolation
- Experience with offline clients, background synchronization, delayed/duplicated event reconciliation
- Exposure to healthcare, HIPAA, SOC 2, encryption, privacy, security, regulated environments
- Experience supporting AI-native, real-time, or agentic product experiences
