Senior Distributed Systems SWE

Senior Distributed Systems Engineer (7+ years)

📍 Hybrid (3 days onsite) – San Francisco

This company is building AI-powered clinical documentation and decision support systems, transforming how healthcare is delivered.

Their platform operates in real-time during doctor-patient interactions, using AI to automate workflows, reduce administrative burden, and improve patient outcomes at scale.

Strong traction:

🚀 ~$45M ARR with rapid growth toward $100M+

🚀 Deployed across 50+ major U.S. health systems

Recognized as a LinkedIn Top Startup (2024 & 2025) and one of the top AI companies in healthcare.

The Role

This is a staff-level infrastructure role focused on building the systems that enable real-time, reliable AI in clinical environments.

You’ll own core platform components including database architecture, caching, and performance optimization - directly impacting latency and reliability in live healthcare workflows.

Key Responsibilities ⚙️

Design and scale database architecture (Postgres, query optimization, indexing, capacity planning)

Build caching systems to remove latency from critical user paths

Optimize system performance across high-traffic, real-time applications

Design rate limiting and load management systems

Improve reliability and observability across core infrastructure

Required Qualifications

7+ years of software engineering experience

Strong backend experience (Python, Go, TypeScript, or similar)

Deep experience with relational databases (Postgres preferred)

Proven experience scaling systems and solving performance/reliability issues

Experience owning infrastructure or platform systems end-to-end

Preferred Qualifications

Experience with high-scale, low-latency systems

Background in infrastructure, platform, or reliability engineering

Experience in healthcare or regulated environments

Startup experience with high ownership

Tech Stack 🛠️

Python, Go, TypeScript

PostgreSQL

Distributed systems + caching layers

Cloud infrastructure (AWS/GCP)

Why This Role

Real-world impact - systems directly affect patient care

High-scale, real-time infrastructure challenges

Frontier AI deployed in production

Strong growth trajectory with clear path to IPO or acquisition

High-caliber engineering team with strong ownership culture.

💡 Interested? Let’s chat.