Job description
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
Originally posted on Himalayas
Who can apply
Eligible countries: United States. Accepted UTC offsets: UTC-10, UTC-9, UTC-8, UTC-7, UTC-6, UTC-5, UTC+14. Review the full description for employer-specific work authorization, residency and schedule requirements.