SENIOR SOFTWARE ENGINEER San Francisco, CA Hybrid About us Metriport is an open-source data intelligence platform that helps healthcare organizations access and exchange patient data in real-time: record retrieval that used to take days now takes seconds, and clinicians walk into every appointment with the full patient picture. We integrate with all major US healthcare IT systems and tap into comprehensive medical data for 300+ million individuals. We've found product-market fit with multi-million ARR, 100+ customers (including Amazon One, Medical Strive Health, Circle Medical, and Brightside Health), backing from top VCs, and years of runway. We're ready to scale. We're a tight-knit, high-performing team of mostly former founders (including two YC alumni). We're engineering-heavy, operate with minimal bureaucracy and high autonomy, and hire based on competence, not prestige. We push hard—founders work six days a week from our SF office—but give everyone freedom to craft their schedule. We measure output and we're committed to sustainable intensity. ABOUT YOU We're looking for "generalist" engineers who can operate at a Senior level: - You're confident in building scalable, distributed systems across the full stack — with particular depth on the back-end — and people usually come to you for technical guidance. - You fully own your work — technical decisions, delivery, results — and you level up the engineers around you through code reviews, pairing, and guidance. Multiplying the team's output energizes you as much as shipping your own. - You're entrepreneurial-minded with an olympian-level work ethic (about half our engineering team are former founders). - You understand reliability, security, and networking end-to-end — designing for uptime, thinking like an attacker to harden your systems, and diving into the network layer yourself rather than treating it as someone else's domain. - You care about delivering value to customers, not about what frilly new tech is under the hood. - When someone scopes a project for 3 weeks, you ask "why can't it be done in 3 days?" — and you help others develop that same instinct. - You're a hacker at heart, with a good sense of which rules should, and shouldn't, be broken. WHAT YOU'LL BE DOING We ingest clinical data for millions of patients from external healthcare sources, with continuous updates for a growing subset of those patients. You'll be a catalyst to scale the platform that powers our product — and ship it to customers fast. Day to day, that looks like: - Raising the technical bar: applying and improving our patterns for low-latency, highly scalable, event-based systems integrations; championing observability into every part of the platform you touch; writing maintainable code that sets the example for others; and making effective use of AI in our product (evals, harnesses, observability). - Working across our back-end-heavy platform: our public API (the core product our customers build on), integrations with health information networks (Carequality, CommonWell, eHealth Exchange) and third parties (EHRs, data vendors, partner platforms), and the platform work that lets the rest of the team ship faster. - Driving projects end-to-end, from ideation to production rollout: writing Design Documents, shipping v0's quickly, and iterating to v1 and beyond. - Multiplying the team: mentoring engineers, reviewing designs and PRs, judging when to invest in quality vs. ship fast, and improving our dev processes and tooling so quality and security are enforced by default. - Participating in bi-weekly sprint planning and retros, joining our daily 30-min remote stand-up at 7:30am PST (our only mandatory meeting), and taking part in the on-call rotation. Example projects you could own: - Refactoring our core data pipeline to process data 10x faster than originally designed. - Using AI/ML to turn freeform doctors' notes into structured data we can add to patients' medical records. - Identifying the biggest infra cost opportunities and shipping the changes — saving money while increasing scalability. - Transforming incoming TCP messages from hospitals using a 90s-era protocol into modern HTTP webhooks routed to our customers. - Leveling up developer experience: making systems easier to test, tightening CI/CD, and cutting the time from PR to production. REQUIREMENTS - 6+ years as a full-stack engineer, with a heavy lean towards back-end — public APIs, distributed systems, and complex integrations with external systems. - Experience developing, maintaining, and scaling cloud-based platforms to many millions or billions of transactions a day — including optimizing architecture and code for scalability and cost. - Experience mentoring or guiding other engineers — through code reviews, pairing, design feedback, or onboarding. - You've made engineering teams faster — better developer experience, more testability, shorter release cycles — and you can talk about the before/after. - You’re located in San Francisco or the Bay Area (or willing to relocate). - Bonus: - Experience processing large amounts of data, including moving it across different services, transforming/consolidating, and building services to query it. - Healthcare standards/technologies: FHIR, HIE, IHE, EHR/EMR, NPI, TEFCA, ADT, HL7, HEDIS, RAF, SNOMED, LOINC, ICD-10, etc. BENEFITS - Competitive equity + compensation package 🚀 - Full family Platinum health insurance, dental, and vision coverage 🦷 - 401(k) retirement plan + matching 💰 - Flexible work from home or in-office 🏢 - Healthy lunches are complimentary when working in-office (and breakfast + dinners as needed) 🍏 - Quarterly company off-sites with the team ⛷️ - MacBook provided by us 💻 - Unlimited PTO (we work hard, but trust you to take time you need to be at your best) 🧘♂️ OUR TECH Core business logic in Node.js and TypeScript, with Pyth