Staff Software Engineer (Backend)
Amigo
About Amigo
Amigo builds AI agents for healthcare. For managed service customers, we are responsible for maintaining and uplifting agent performance, ensuring clinical safety and continuous improvement of patient outcomes.
Our agents operate autonomously within bounded clinical domains. Clear inclusions, exclusions, and handoff protocols. The scope of autonomous operation expands over time as we validate performance across patient populations.
Backend systems serve millions of patient conversations across multiple regions. The work includes real-time inference, multi-LLM orchestration, EHR integrations with legacy healthcare systems, and security for regulated environments.
Series A from leading investors. Clinical validation and evidence generation in partnership with leading academic medical institutions.
About this role
As a Staff Software Engineer (Backend) at Amigo, you'll own the technical direction of the backend systems that power our agent platform at scale. You'll architect high-performance services handling millions of conversations, drive engineering standards, and make critical decisions on system design for real-time inference, LLM orchestration, and healthcare integrations.
You'll mentor engineers, shape technical culture, and ensure we maintain elite engineering standards as the team grows. These systems handle sensitive patient data and support clinical workflows—correctness and reliability are non-negotiable.
What you'll do
Own technical architecture for backend systems including real-time inference, multi-LLM orchestration, and conversation handling
Drive engineering standards for code quality, testing, observability, and incident response
Architect high-performance services that handle concurrent requests at scale with predictable latency
Design integration patterns for EHR systems and legacy healthcare infrastructure
Own the approach to distributed systems challenges: consensus, replication, fault tolerance
Make build vs. buy decisions and evaluate technical tradeoffs across the backend stack
Design APIs and service-oriented architectures that power the agent platform
Architect secure data handling for sensitive healthcare information with proper access controls
Own monitoring, logging, and observability architecture for backend services
Mentor engineers and establish patterns that raise the bar for the entire team
Collaborate with platform, infrastructure, and agent teams to ensure system-wide coherence
Define reliability targets and drive operational excellence across backend systems
What we're looking for
7+ years of production backend engineering experience, with significant time at elite engineering organizations
Expert-level experience with backend development in Python, Go, or similar languages
Proven track record designing distributed systems that scale—you've built and operated high-traffic production services
Deep experience with concurrency programming, including threads, async operations, and parallelism
Strong understanding of distributed systems concepts (consensus, replication, partitioning) and when to apply them
Experience with message queuing systems, event streaming, and async communication patterns at scale
History of establishing engineering standards and mentoring engineers
Extremely high standards for code quality, reliability, and operational excellence
Both execution-oriented and defensive-minded: you ship fast while anticipating failure modes
Deep knowledge of database systems, both SQL and NoSQL, and their scaling characteristics
Excellent written and verbal communication across engineering and executive stakeholders
Nice to have
Experience with healthcare systems, EHR integrations, or HIPAA compliance at scale
Background with real-time inference systems or LLM orchestration
Experience with high-throughput, low-latency system design
Track record building and scaling engineering teams
Understanding of observability and monitoring in distributed environments
Benefits
Health & Wellness
Comprehensive health, dental, and vision insurance
Mental health support and wellness coaching
Flexible wellness stipend for fitness, therapy, or personal growth
Daily catered lunch and dinner
Growth & Development
Annual learning budget for courses, books, or conferences
Conference attendance budget for professional development
Development setup of your choice
Academic collaboration opportunities