Staff / Senior Backend Engineer

Role summary

As the third dedicated backend hire, you’ll be joining a team of 5 developers. You’ll own the design and delivery of many of Prysm’s core clinical backend systems: clinical API surfaces, onboarding/migration flows to Prysm from legacy vendors, MDS billing architecture and reporting, and integrations that make nurse-centric automation possible. You’ll be hands-on building production systems, setting the bar for engineering at Prysm, and directly involved with hiring and scaling the backend team.

What you’ll do (core responsibilities)

• Design and build Prysm’s core clinical APIs and backend services in TypeScript on AWS in Nest.js / Node.js.

• Model a genuinely complex clinical domain: assessments, orders, care plans, staff scheduling in PostgreSQL and Prisma.

• Lead the design and implementation of the onboarding/migration flow for facilities moving onto Prysm; own data mapping, migration reliability, and operator experience.

• Set the standard for code quality, testing, CI/CD, monitoring, and security practices (HIPAA & SOC2 readiness is important).

• Partner regularly with the CNO and facility operators: visit facilities to observe workflows, incorporate nurse feedback, and iterate quickly.

• Collaborate closely with product and design to ensure engineering solutions are operator-centric and deliver value fast.

• Build out monitoring and reporting platforms with Sentry, Datadog, and AWS.

What you have

• 5+ years of backend production engineering experience, with a track record of owning systems in production.

• Strong TypeScript experience (or similar language) or the ability to pick it up from another strongly typed language and production experience on AWS or similar Cloud Platform Solutions.

• Experience designing APIs, database schemas and backend services for complex domains.

• Strong product orientation: you write code to define requirements, scope projects and development, and iteratively deliver.

• Excellent communicator who can work with clinical stakeholders and non-technical operators.

• Willingness to travel to facilities periodically to understand product usage in the real world.

Nice-to-have

• Experience with healthcare standards such as FHIR, MDS, or HL7, previous work integrating with EHRs, or previous experience working with industry standardized data formats

• Experience with HIPAA, SOC2 readiness, and security/compliance engineering.

• Experience with OCR, medication mapping, or rules-based AI/automation.

• Prior experience building from scratch in a startup or working closely with operator / clinical teams in the field.

• Experience with infrastructure as code (terraform).

• Comfort working across the stack.

• Preferred living in SF/NYC/LA/Boston