Staff Software Engineer (Backend)

Amigo

Amigo

Software Engineering
New York, NY, USA
Posted on Dec 9, 2025

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