Senior Software Engineer - Backend/Infra

Concurrence

San Francisco, California, United States · New York, New York, United StatesFull-timePosted Oct 16, 2026

About the role

About Concurrence

At Concurrence, we're building the clinical AI infrastructure that health systems, life sciences companies, payers, and government agencies run their patient-facing care on. Our agents work across the whole patient journey: pre-visit intake, care navigation, post-visit care plans, and ongoing monitoring. Our mission is to make excellent care accessible to every patient, not rationed by the limits of clinician time.

This hasn’t been solved because the underlying record was never built for it. EHRs were designed for billing, not for systems that learn. So instead of layering another point solution on top, we’re rebuilding the medical record as a timeline of clinical events and running agents on top of it that improve with every patient interaction. Unlike single-purpose chatbots or scribes, Concurrence is the platform our customers use to build their own agents. That means our work has to hold up across specialties, workflows, and regulatory environments, and not just one narrow use case.

Our agents have supported more than 10 million patient encounters and are on track to grow tenfold this year. Our work is validated through partnerships with leading academic medical institutions. We’re fresh off our Series A, backed by Tier 1 VCs such as Madrona, General Catalyst, and Optum Ventures.

We’re a small team of around 35 people, working in person in New York City and San Francisco. We care deeply about craft, clinical rigor, and the speed at which good ideas reach patients. If you want your work to be measured in outcomes rather than releases, we’d like to hear from you.

About this role

As a Senior Backend/Infra Engineer at Amigo, you'll build the core services behind our agent platform. The systems you own handle millions of conversations a month, so concurrency, reliability, and clean design are the job itself, not an afterthought. You'll own services end to end, from design through production.

What you'll do

Designing high-throughput services that handle concurrent conversations at scale

Owning a core platform service from design to production

Building systems that stay available and degrade gracefully when things fail

Handling sensitive healthcare data with the care it requires

Improving performance, observability, and operational health across services

Shaping architectural decisions as the platform grows

Think carefully and holistically about system design under time pressure.

What we're looking for

You've built and operated production backend systems at scale and owned the outcome

You're strong with concurrency, distributed systems, and service design

You prefer simple, maintainable solutions to hard problems

You debug well across services, queues, and databases

You're low ego, direct, and hold yourself to a high bar

You can work on site in New York City or San Francisco

Nice to have

Experience in a regulated or high-reliability domain (healthcare, finance, legal)

High-throughput or low-latency system design

Experience with production AI or ML systems

Benefits (available to Full-Time Employees)

Health & Wellness

Comprehensive health, dental, and vision insurance

Daily catered lunch and dinner

Mental health support and wellness coaching

Flexible wellness stipend for fitness, therapy, or personal growth

Growth & Development

Annual learning budget for courses, books, or conferences

Conference attendance budget for professional development

Annual team offsite

Academic collaboration opportunities

Unlimited PTO

Our Core Values

Patients Win, We Win

If patients aren't getting better care, we haven't earned the right to scale. Every internal decision gets pressure-tested: does this make patients' lives better? If we can't draw the line, we question why we're doing it.

High Standards, High Care

We hold a high bar for the team because patients are counting on us to get this right. But high standards only work with genuine investment in each other. You can take risks, admit mistakes, and challenge ideas. Not despite our standards, but because of them.

Thoughtful Urgency

We move fast by default, but speed without judgment is recklessness. The discipline is knowing which decisions are reversible vs. not. In healthcare AI, the companies that win will be fast everywhere they can be and careful everywhere they must be. We build the muscle to do both.

Intensely Measured

We instrument patient outcomes, provider ROI, system performance, and clinical accuracy. But data without action is surveillance. Every metric should have an owner, a threshold, and a response plan. If we're measuring something but never acting on it, we stop measuring it.

Who Builds With Us

Low ego: Politics and territory don't interest you. The best ideas win, regardless of who has them.

Direct: You say the hard thing, challenge ideas openly, and commit fully once decided.

High agency: You thrive on trust rather than instruction. When you see something is broken, you fix it. You don’t file tickets and wait for someone else.

Bar of excellence: You hold yourself to a bar most people wouldn't, and you want teammates who do the same.

Skeptical: You push back on rules that don’t make sense and question assumptions that haven’t earned their place.

Responsibilities

  • Design high-throughput services for concurrent conversations at scale
  • Own core platform services from design through production
  • Build reliable systems that degrade gracefully when failures occur
  • Handle sensitive healthcare data responsibly
  • Improve service performance, observability, and operational health
  • Shape platform architecture as the company grows

Qualifications

  • Experience building and operating production backend systems at scale
  • Strong understanding of concurrency, distributed systems, and service design
  • Ability to design simple, maintainable solutions to complex problems
  • Strong debugging skills across services, queues, and databases
  • Able to work on site in New York City or San Francisco
  • Experience in regulated or high-reliability domains, high-throughput or low-latency systems, or production AI/ML systems is a plus

Benefits

  • Comprehensive health, dental, and vision insurance
  • Daily catered lunch and dinner
  • Mental health support and wellness coaching
  • Flexible wellness stipend
  • Annual learning and conference budgets
  • Annual team offsite
  • Academic collaboration opportunities
  • Unlimited PTO

Skills mentioned

Backend DevelopmentSystem DesignDistributed SystemsConcurrencyMicroservicesPerformance OptimizationDebuggingCloud ComputingDevOpsPrometheus

About Concurrence

Concurrence (formerly known as Amigo) is the data and AI company creating empirical convergence on what works in healthcare. We partner with health systems, biopharma companies, and public health agencies to unify their data and deploy AI that learns from every act of care. Enterprise deployment is supported by native integrations with all major EHRs (Epic, Oracle Health, Athenahealth, and more) and full HIPAA, SOC 2 Type II, and GDPR compliance. To date, the Concurrence platform has driven over 10 million patient interactions.

Hospitals and Health Care11-50 employeesNew York, NY