# Lead Engineer (Backend)

**Company:** [Onos Health](https://hotfix.jobs/companies/onos-health)
**Location:** San Francisco, CA
**Role:** Backend Engineering
**Salary:** $200k – $250k/yr
**Experience:** 5+ years
**Skills:** Python, Django, AWS, Postgres, Docker, Terraform, Celery, Next.js, TypeScript, Machine Learning
**Posted:** 2025-12-17

> Leads backend development of AI-driven healthcare platform, architecting ML workflows for claims processing and care optimization. Owns end-to-end features, establishes best practices, and guides technical strategy with 5+ years experience and team leadership.

## Job Description

## Responsibilities
- Architect workflows that utilize AI/ML to process claims, medical records and other data types to evaluate the optimal care path for health plan members
- Lead the integration and rollout of the Onos platform for new enterprise customers to provide actionable insights and recommendations to health plan administrators
- Own end-to-end development of new features and functionality for the Onos platform, including requirements gathering, scoping, architecting, implementation and testing
- Establish engineering best practices and technical foundations for future team growth
- Shape our technical roadmap, make key architectural decisions, and influence the company's product and technical strategy

## Technical Challenges
- Develop an intelligent engine that ingests complex medical standards of care documents and evaluates provider adherence to guidelines
- Design and implement robust and extensible systems to easily support many different kinds of enterprise workflows and integrations
- Build AI/ML pipelines to analyze handwritten clinical notes, accurately extract important medical information, and automate recommendations for clinical reviewers
- Scale our systems to process millions of healthcare records while maintaining strict security and compliance requirements

## Tech Stack
**Infrastructure/Systems:** AWS (ECS, Bedrock, Glue, etc.), Docker, Github Actions, Terraform  
**Backend:** Python, Django, Celery / Celery Beat, django-ninja, django-tenants  
**Frontend:** NextJS, Typescript, Tanstack Query, Shadcn UI, Zod, Nuqs  
**Database/Storage:** PostgreSQL (AWS RDS), S3, Clickhouse  
**Development Tools:** Github, Jira, Claude Code, CoderabbitAI, Tusk

## Requirements
- 5+ years experience building software applications
- Prior experience leading engineering teams as a tech lead or engineering manager
- Strong product sense and system design skills with a track record of defining clear requirements, test scenarios, and acceptance criteria for complex systems
- Customer obsessed and motivated to make an impact in the healthcare space
- A hands-on technical leader who can architect robust and extensible systems, establish best practices with AI coding tools, and ship high quality production code

## Nice-to-Haves
- Worked with machine learning and large language models for end-user applications
- Hands-on experience navigating healthcare data formats such as EDI X12, HL7, FHIR, and custom payer flat files

## Benefits
- Flexible hybrid arrangement: 2-3 days/week at San Francisco office (Financial District), remote-first culture
- Unlimited vacation policy
- Paid parental leave
- Medical, dental, and vision insurance
- Pre-tax commuter benefits
- 401(k)
- Significant equity as an early employee
- Direct mentorship from experienced founders
- Ground-floor opportunity to help build a team and culture
- Regular team events and offsites
- Company-provided equipment and home office setup

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**Apply:** https://hotfix.jobs/jobs/7545557a-8213-40e1-8f87-1a1198fa7ea3
**Canonical:** https://hotfix.jobs/jobs/7545557a-8213-40e1-8f87-1a1198fa7ea3