Senior Backend Engineer
Wellth.com
150k - 180k USD/year
Office
Los Angeles, CA
Full Time
Base Compensation: $150K - $180K
Engineer Healthcare Solutions That Demonstrate Technical Excellence And Leadership
Join Wellth's engineering team, where your technical expertise and leadership abilities will directly impact healthcare outcomes. Our systems have prevented 15,000 hospital days and saved 530 lives by reducing hospitalization rates up to 44% for underserved populations.
As a Senior Backend Engineer, you'll architect distributed systems while demonstrating the technical depth and leadership skills needed to drive complex projects to completion. You'll balance deep technical work with cross-functional collaboration, ensuring our systems scale efficiently while maintaining 99.9% uptime for 50,000+ daily patient interactions.
What We'Re Looking For: Technical Depth Meets Leadership Impact
Successful Candidates Demonstrate:
Deep Technical Expertise
- Proven scale experience: You've built and operated production systems handling 10K+ RPS, with hands-on experience in debugging, optimization, and capacity planning
- Distributed systems mastery: You've designed event-driven architectures using message queues (Kafka, RabbitMQ, SQS) and can articulate complex debugging scenarios you've solved
- Observability excellence: You use distributed tracing and APM tools (DataDog, New Relic) strategically, not just logs. You can share specific examples of how custom metrics and dashboards helped you prevent or resolve production issues quickly.
- Database optimization: You've improved query performance by 50%+ and implemented caching strategies that scaled systems to millions of users
Leadership Through Ownership
- Project leadership with impact: Led technical initiatives that delivered measurable business value under challenging constraints or tight deadlines
- Incident command experience: Served as incident commander for critical outages, leading cross-team response efforts and driving systematic improvements through comprehensive post-mortems
- Technical mentorship: Elevated team capabilities through code reviews, architecture discussions, and knowledge sharing
- Strategic technical decisions: Made and communicated architectural trade-offs that balanced immediate needs with long-term scalability
Critical Technical Requirements
Non-Negotiable Experience:
- 5+ years building Node.js/TypeScript services in production at scale
- 3+ years with event-driven architectures and asynchronous processing patterns
- Deep hands-on experience with observability tools and distributed tracing
- Proven track record with on-call rotations and incident response leadership
- Experience optimizing both SQL and NoSQL databases for performance and scale
- Strong background in AWS services (EC2, RDS, SQS, Lambda, DynamoDB)
- Infrastructure as Code expertise (Terraform or CloudFormation)
How We Evaluate Senior Engineers
During our technical interviews, we assess:
System Design Approach
- Do you ask clarifying questions about scale, data consistency, latency requirements, and business constraints?
- Can you articulate multiple solutions and explain trade-offs?
- Do you consider operational aspects like monitoring, debugging, and maintenance?
- Can you identify potential failure modes and mitigation strategies?
Problem-Solving & Communication
- Do you think out loud and clearly explain your reasoning?
- Can you break down complex problems into manageable components?
- Do you consider both technical and business constraints?
- Can you adapt when requirements change or new information emerges?
Operational Excellence
- Can you describe specific production issues beyond "we had a problem and rolled back"?
- What observability strategies have you implemented proactively?
- How have you reduced MTTR or prevented incidents?
- Can you explain your debugging process for distributed system failures?
Ownership & Impact
- What challenging projects have you driven to completion?
- How did you navigate technical and organizational obstacles?
- What was the measurable impact of your work?
- How did you ensure long-term maintainability?
Your Responsibilities And Impact
Technical Leadership:
- Design and implement event-driven systems processing millions of healthcare interactions
- Own service architecture decisions impacting system reliability and scalability
- Lead technical design reviews and architectural decision records
- Drive adoption of engineering best practices across the team
Operational Excellence:
- Serve as incident commander during critical outages
- Implement observability strategies that reduce MTTR by 50%+
- Build self-healing systems with automated remediation capabilities
- Create runbooks and documentation enabling team scalability
Cross-Functional Impact:
- Partner with product managers to translate business requirements into scalable technical solutions
- Collaborate with data engineers on pipeline architecture and data quality initiatives
- Work with QA engineers to implement comprehensive testing strategies
- Communicate technical decisions and trade-offs to stakeholders
Team Development:
- Mentor junior engineers through pairing, code reviews, and technical discussions
- Lead brown bags and technical talks on distributed systems topics
- Contribute to engineering hiring and interview process improvements
- Document architectural patterns and technical decisions for team knowledge sharing
The Technical Challenges Ahead
- Scale our event-driven architecture from handling thousands to millions of daily healthcare events while maintaining data consistency
- Build fault-tolerant workflows orchestrating complex healthcare processes across 20+ microservices
- Optimize data pipelines processing PHI data with HITRUST compliance requirements
- Implement predictive monitoring that identifies issues before they impact production
- Design cost-effective solutions, balancing performance with infrastructure costs
- Evolve our platform to support new healthcare initiatives and regulatory requirements
Technology Stack
Core Technologies:
- Node.js, TypeScript, Express
- PostgreSQL, DynamoDB, Redis
- Kafka, SQS/SNS, EventBridge
- AWS (Lambda, ECS, RDS, S3)
- DataDog (APM, Logs, Metrics, Traces)
- Terraform, GitHub Actions
Engineering Practices:
- Event-driven microservices architecture
- Infrastructure as Code
- Continuous deployment with feature flags
- Comprehensive testing (unit, integration, load)
- On-call rotation with blameless post-mortems
Team & Culture
You'Ll Join:
- Senior engineers from top tech companies who value technical excellence
- A collaborative environment where good ideas come from anywhere
- A team that celebrates both individual contributions and collective success
- Regular tech talks, architecture reviews, and learning opportunities
- Direct partnership with a Director of Engineering focused on your growth
Growth & Development
- Clear progression path to Staff Engineer or Engineering Management
- Opportunity to lead critical technical initiatives
- Mentorship from senior technical leaders
- Exposure to healthcare technology and regulatory challenges
Benefits & Flexibility
- Work arrangement: Flexible hybrid with remote-first practices
- Time off: Generous PTO and parental leave
- Health & financial: Comprehensive insurance, FSA/HSA, equity compensation
- Location: Optional access to Marina Del Rey office
- Mission: Direct impact on healthcare accessibility and outcomes
Ready To Make An Impact?
We're looking for engineers who combine technical excellence with the ability to drive results. If you've built systems at scale, led through challenging technical problems, and want to apply your skills to meaningful healthcare challenges, we want to hear from you.
Wellth is an equal-opportunity employer. We value diverse perspectives and backgrounds in building technology that serves everyone.
Senior Backend Engineer
Office
Los Angeles, CA
Full Time
150k - 180k USD/year
September 22, 2025