# Software Engineer, Systems
**Company:** [Midstream Health](https://hotfix.jobs/companies/midstream-health)
**Location:** San Francisco, CA
**Salary:** $170K-$230K
**Skills:** Kubernetes, Terraform, AWS, GCP, API Design, CI/CD, Multi-Tenancy, Distributed Systems, Observability, Backend Services
**Posted:** 2026-01-29
> Builds scalable distributed systems, platform tooling, and backend services for an AI-native healthcare financial platform. Focuses on multi-tenancy, reliability, observability, and developer experience using cloud infrastructure like Kubernetes and Terraform.
## Job Description
## What You’ll Do
- Build shared platform patterns and tooling that help engineers ship new backend services and workflows quickly, safely, and consistently.
- Strengthen the reliability of our production systems by improving observability, debugging, and resilience as we scale.
- Design infrastructure that is clean, reviewable, and repeatable—reducing one-off configurations and enabling faster iteration.
- Establish clear and scalable multi-tenant boundaries across data, compute, and identity to support enterprise healthcare customers.
- Help ensure the team can spend more time building new capabilities—and less time maintaining systems—as customer usage and data volume grow.
- Build the agentic orchestration layer for tools and agents to power our natural language analytics that enables rapid discovery of insights with source document traceability.

## Who You Are
- Strong instincts for designing distributed systems and scalable SaaS platforms, with a focus on clear ownership, isolation, and reliability.
- Understand core platform building blocks like **API design**, **CI/CD**, **multi-tenancy**, and **role-based access control**.
- Deeply comfortable in modern cloud environments (**AWS** or **GCP**) and experience with **infrastructure-as-code** tools like **Terraform** and **Kubernetes**.
- Leverage cloud-native services for computing, storage, and ML-enabled applications.
- Treat infrastructure as software and care about developer experience, creating reusable patterns, templates, and automation.
- Strong backend engineer who writes high-quality services and pipelines, comfortable building **APIs**, asynchronous workflows, background jobs, integrations, and foundational systems.
**Apply:** https://hotfix.jobs/jobs/software-engineer-systems-at-midstream-health-c9fd70a6-ff3d-4ec4-97d2-8af5c2c14981
**Canonical:** https://hotfix.jobs/jobs/software-engineer-systems-at-midstream-health-c9fd70a6-ff3d-4ec4-97d2-8af5c2c14981