Job Summary:
Mochi Health is an innovative company aiming to transform the healthcare landscape by connecting patients with the right care and affordable medications. They are seeking a Senior Backend Engineer to architect and own core systems that support their rapidly growing healthcare platform, focusing on complex medication ordering, billing infrastructure, and clinical workflows.
Responsibilities:
• Architect Healthcare Commerce: Build and evolve a subscription and billing infrastructure that handles the messy reality of healthcare. You will solve for mid-cycle medication switches, dynamic pricing across different pharmacy partners, payment recovery, and prorated billing.
• Build Clinical State Machines: Own the systems that power complex medication ordering and fulfillment. You will build highly reliable pipelines that handle compounding pharmacy integrations, controlled substance compliance, and personalized dosing protocols across a distributed network of external partners.
• Own the Infrastructure: Take hands-on ownership of the AWS and Kubernetes infrastructure that runs your services. You will establish CI/CD pipelines, build observability, and create deployment patterns that make it safe for the entire team to ship rapidly.
• Act as a Product Partner: Work directly with Clinical, Operations, and Product teams to shape what we build. You will evaluate proposed workflows, take ownership of business outcomes, and actively identify paths to deliver maximum patient value with highly efficient implementation.
• Build Agentic Workflows: Mochi is an AI-first engineering org. You will not only utilize frontier agentic models to accelerate your own development, but you will also design the backend architecture that allows AI-assisted agents to automate clinical operations, improve patient safety, and scale our provider workflows.
• Raise the Engineering Bar: Own key architectural decisions, systematically upgrade legacy systems, and elevate the engineers around you through rigorous code review, testing practices, and technical standards.
Qualifications:
Required:
• 5-7+ years of backend engineering experience.
• Experience building and operating production systems that handle real complexity.
• Experience with complex domain logic, distributed stateful workflows, and deep integrations with external partners.
• Strong understanding of schema design, state transitions, and domain boundaries.
• Comfortable with (or eager to master) Kubernetes, Terraform, AWS, and CI/CD.
• Experience deploying your own code and owning your system's reliability.
• Experience using frontier agentic tools (e.g., Codex 5.3, Claude Opus 4.6) to build faster.
• Excellent communication skills and ability to thrive in cross-functional environments.
• Excited to work in-person 5 days a week in the San Francisco office.
Preferred:
• Demonstrated track record of setting technical direction across teams.
• Experience navigating deep ambiguity and measurably leveling up the engineers around you.
• Experience with TypeScript, Node.js, Express, PostgreSQL, Redis.
Company:
Mochi Health operates a three-sided telehealth marketplace connecting patients, providers, and pharmacies Founded in 2022, the company is headquartered in San Francisco, USA, with a team of 51-200 employees. The company is currently Growth Stage.