About Steer HealthSteer Health is the AI-native growth and automation platform for healthcare. Health systems, hospitals, and specialty medical groups use our platform to attract and convert patients, automate front-office and clinical workflows, and accelerate revenue. Our AI agents answer calls, book appointments, document visits, and close operational gaps around the clock, connected directly to the systems clinicians already use.The platform integrates with 36 EHRs, including direct Epic integration with SSO, and serves provider organizations nationwide, covering millions of patient lives. Steer Health is a KLAS Emerging Solutions Top 20 company, an athenahealth Marketplace certified partner, and winner of the 2026 Hearst Health Prize.The RoleWe are hiring a Senior Backend Engineer to design, build, and scale the core services behind our platform. You will work on event-driven pipelines that move clinical and operational data in real time, integrations with EHRs and third-party systems, and the backend infrastructure that powers our AI agents. This is a high-ownership role: you will take problems from architecture through production and operate what you ship.What You Will DoDesign, build, and operate backend services and APIs in Node.js and TypeScriptArchitect and extend our event-driven systems on Kafka, including topic design, producers and consumers, stream processing, delivery guarantees, and back-pressure at scaleOwn MongoDB data modeling and performance, including schema design, indexing, aggregation pipelines, replication, and query optimizationBuild reliable, secure integrations with EHRs, healthcare data standards (FHIR, HL7), and third-party APIsSupport AI agent workflows with fast, resilient backend services and real-time data pipelinesDrive reliability and observability: monitoring, alerting, load testing, incident response, and postmortemsHandle PHI responsibly and uphold HIPAA-grade security practices across every service you touchRaise the engineering bar through design docs, code reviews, and mentoringRequirementsMust-Have Qualifications5+ years of backend engineering experience with clear senior-level ownership of production systemsExpert-level Node.js and TypeScript in production environmentsHands-on experience designing and operating Kafka-based eventing architecturesDeep MongoDB experience at scale, including schema design, indexing strategy, and performance tuningA track record of building and scaling systems at a high-growth or high-traffic companyStrong API design fundamentals and disciplined habits around testing, code quality, and documentationStrongly PreferredHealthcare or health tech background, including EHR integrations, FHIR or HL7, HIPAA, and PHI handlingExperience at a high-scaling technology company where reliability and throughput were mission criticalNice to HaveCloud infrastructure experience (AWS preferred), Docker, and KubernetesRedis or other caching and search layersExposure to LLM or AI product pipelinesEarly-stage startup experience and comfort with ambiguityOur StackNode.js, TypeScript, Kafka, and MongoDB, with Next.js on the front end and a purpose-built eventing engine at the core of the platform.BenefitsWhy Join Steer HealthBuild AI that measurably improves how patients access and receive care, at real scaleHigh ownership and direct access to the founding team; your work ships fast and mattersAward-winning product with strong market momentumCompetitive salary, equity, and benefitsSteer Health is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all
About Steer Health
Steer Health is the AI-native growth and automation platform for healthcare. Health systems, hospitals, and specialty medical groups use our platform to attract and convert patients, automate front-office and clinical workflows, and accelerate revenue. Our AI agents answer calls, book appointments, document visits, and close operational gaps around the clock, connected directly to the systems clinicians already use.
The platform integrates with 36 EHRs, including direct Epic integration with SSO, and serves provider organizations nationwide, covering millions of patient lives. Steer Health is a KLAS Emerging Solutions Top 20 company, an athenahealth Marketplace certified partner, and winner of the 2026 Hearst Health Prize.
The Role
We are hiring a Senior Backend Engineer to design, build, and scale the core services behind our platform. You will work on event-driven pipelines that move clinical and operational data in real time, integrations with EHRs and third-party systems, and the backend infrastructure that powers our AI agents. This is a high-ownership role: you will take problems from architecture through production and operate what you ship.
What You Will Do
- Design, build, and operate backend services and APIs in Node.js and TypeScript
- Architect and extend our event-driven systems on Kafka, including topic design, producers and consumers, stream processing, delivery guarantees, and back-pressure at scale
- Own MongoDB data modeling and performance, including schema design, indexing, aggregation pipelines, replication, and query optimization
- Build reliable, secure integrations with EHRs, healthcare data standards (FHIR, HL7), and third-party APIs
- Support AI agent workflows with fast, resilient backend services and real-time data pipelines
- Drive reliability and observability: monitoring, alerting, load testing, incident response, and postmortems
- Handle PHI responsibly and uphold HIPAA-grade security practices across every service you touch
- Raise the engineering bar through design docs, code reviews, and mentoring
Requirements
Must-Have Qualifications
- 5+ years of backend engineering experience with clear senior-level ownership of production systems
- Expert-level Node.js and TypeScript in production environments
- Hands-on experience designing and operating Kafka-based eventing architectures
- Deep MongoDB experience at scale, including schema design, indexing strategy, and performance tuning
- A track record of building and scaling systems at a high-growth or high-traffic company
- Strong API design fundamentals and disciplined habits around testing, code quality, and documentation
Strongly Preferred
- Healthcare or health tech background, including EHR integrations, FHIR or HL7, HIPAA, and PHI handling
- Experience at a high-scaling technology company where reliability and throughput were mission critical
Nice to Have
- Cloud infrastructure experience (AWS preferred), Docker, and Kubernetes
- Redis or other caching and search layers
- Exposure to LLM or AI product pipelines
- Early-stage startup experience and comfort with ambiguity
Our Stack
Node.js, TypeScript, Kafka, and MongoDB, with Next.js on the front end and a purpose-built eventing engine at the core of the platform.
Benefits
Why Join Steer Health
- Build AI that measurably improves how patients access and receive care, at real scale
- High ownership and direct access to the founding team; your work ships fast and matters
- Award-winning product with strong market momentum
- Competitive salary, equity, and benefits
Steer Health is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all
Steer Health is on a mission to modernize patient experience with its user-friendly healthcare telemedicine enterprise that empowers healthcare providers to deliver personalized patient care in real-time resulting in new practice revenues, enhanced staff efficiencies, and higher levels of patient satisfaction.. Our company was founded in an unusual way; with customers and revenue from the beginning! Our growth is already ahead of some of the most successful software start-ups, and we don’t plan on slowing down.We believe our opportunity is huge. Every Medical group and hospital in the world suffers from patient engagement problems. Traditional EHR products approach the problem with old solutions that breed inefficiency and ultimately can’t help hospital and practice admins to deliver care to patients in a secure manner.Steer Health provides a modern solution that addresses these data silo & EHR shortcomings. Steer Health helps healthcare enterprises harness the value of our all-in-one virtual care platform, by adding the patient outreach tools and 24x7 support that meet all virtual care needs. Ultimately, Steer Health helps organizations deliver superior care anywhere resulting in new revenues and enhanced staff productivity.
Steer Health is on a mission to modernize patient experience with its user-friendly healthcare telemedicine enterprise that empowers healthcare providers to deliver personalized patient care in real-time resulting in new practice revenues, enhanced staff efficiencies, and higher levels of patient satisfaction.. Our company was founded in an unusual way; with customers and revenue from the beginning! Our growth is already ahead of some of the most successful software start-ups, and we don’t plan on slowing down.
We believe our opportunity is huge. Every Medical group and hospital in the world suffers from patient engagement problems. Traditional EHR products approach the problem with old solutions that breed inefficiency and ultimately can’t help hospital and practice admins to deliver care to patients in a secure manner.
Steer Health provides a modern solution that addresses these data silo & EHR shortcomings. Steer Health helps healthcare enterprises harness the value of our all-in-one virtual care platform, by adding the patient outreach tools and 24x7 support that meet all virtual care needs. Ultimately, Steer Health helps organizations deliver superior care anywhere resulting in new revenues and enhanced staff productivity.
