Original listing text, shown exactly as published by the company.
About the Role
Kinstead is hiring a Senior Backend Engineer to build and own core backend systems and application logic.
You’ll design and build the services that power reliable clinical and operational workflows, including APIs, background processing, and system behavior under real-world conditions. This role focuses on reliability, correctness, and predictable execution as the product grows.
You do not need prior healthcare or FHIR experience. They care more about strong backend fundamentals, sound engineering judgment, and the ability to ramp quickly on a complex domain.
You’ll work closely with the CTO on system design while maintaining ownership of implementation and operational correctness.
Responsibilities
- Design and implement backend workflows and application logic
- Build and maintain APIs that power product functionality
- Implement scheduling, encounter, and operational workflows
- Build AI-powered tools that help clinicians with documentation, clinical decision support, and voice-driven workflows
- Integrate with clinical systems using FHIR
- Debug and resolve production issues across the stack
- Ensure system behavior remains predictable under failure conditions
- Collaborate with frontend engineers to maintain clear API contracts
- Use AI development tools to accelerate implementation while maintaining reliability
- Participate in system design and technical planning
Requirements
- 5+ years building production software systems
- Strong Python experience.
- Familiarity with asynchronous programming in any language.
- Experience designing and maintaining APIs for production applications
- Experience building backend systems beyond request/response — background jobs, event-driven patterns, or async processing
- Strong debugging and problem-solving skills
- Ability to design systems that behave predictably when things go wrong
- Comfort working in an AI-assisted development workflow
Nice to Have
- Experience with React or NextJS
- Experience building workflow or state-machine-driven systems
- Experience reasoning about stateful systems
- Experience with FHIR or healthcare data systems (helpful but not required)
- Experience with Kubernetes or distributed systems
- Experience working in early-stage startups
Tech Stack
- Python (Django, async-first with django-ninja and Channels), Next.js, PostgreSQL (with pgvector), Redis, WebSockets, asynchronous background jobs, workflow state machines, and clinical integrations using Medplum and FHIR.
- Kinstead services run on AWS and Kubernetes, and we rely on Terraform for IaC and Datadog for APM and infrastructure monitoring.
- They maintain automated testing and deployment pipelines using Github Actions and integrate with AI providers including Google (Vertex AI), Anthropic (AWS Bedrock), and OpenAI.
