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Amigo is building clinical AI infrastructure that health systems, life sciences companies, payors, and government agencies use to run patient-facing care. The platform powers AI agents that work across the entire patient journey—pre-visit intake, care navigation, post-visit care plans, and ongoing monitoring. Unlike point-solution chatbots or scribes, Amigo is a platform that customers use to build their own agents, requiring the system to work across specialties, workflows, and regulatory environments.
The company has rebuilt the medical record as a timeline of clinical events with agents running on top that improve with every patient interaction. Amigo's agents have supported over 4 million patient encounters and are on track to grow tenfold this year. The company is backed by Tier 1 VCs including Madrona, General Catalyst, and Optum Ventures, fresh off Series A, with a team of ~35 people working in-person in New York City and San Francisco.
As a Staff Backend/Infrastructure Engineer, you will build the core services behind the agent platform. The systems you own handle millions of conversations monthly, making concurrency, reliability, and clean design central to the role. You will own services end-to-end, from design through production.
Key responsibilities include: designing high-throughput services handling concurrent conversations at scale; owning a core platform service from design to production; building systems that stay available and degrade gracefully under failure; handling sensitive healthcare data appropriately; improving performance, observability, and operational health across services; shaping architectural decisions as the platform grows; and thinking carefully and holistically about system design under time pressure.
The company values patients winning, high standards with genuine care, thoughtful urgency (moving fast where reversible, careful where not), and being intensely measured with actionable metrics. The culture emphasizes low ego, directness, high agency, excellence, and healthy skepticism.
REQUIREMENTS:
- You have built and operated production backend systems at scale and owned the outcome
- Strong expertise in concurrency, distributed systems, and service design
- Preference for simple, maintainable solutions to hard problems
- Ability to debug well across services, queues, and databases
- Low ego, direct communication style, and high personal standards
- Must be able to work on-site in New York City or San Francisco
NICE TO HAVE:
- Experience in regulated or high-reliability domains (healthcare, finance, legal)
- High-throughput or low-latency system design experience
- Production AI or ML systems experience
