Senior Backend Engineer (Event-Driven Architecture, AI-Enabled Systems)

Legion; San Francisco (CA); On-site; USD 120,000 - 180,000; Full time

Job summary

A leading company in AI-driven healthcare is seeking a Senior Backend Engineer to design a scalable and efficient backend. The role involves building event-driven systems integrated with AI to enhance patient care. The ideal candidate will have substantial experience in backend engineering, focusing on real-time data processing and AI solutions.

Benefits

Equity options

High-velocity work environment

Mission-driven impact in healthcare

Qualifications

• 5+ years of experience in backend engineering.
• Expertise in event-driven systems and message queues required.
• Comfort working with LLMs, strong compliance mindset preferred.

Responsibilities

• Design and implement scalable backend architecture using Node.js.
• Integrate AI workflows for patient and provider optimization.
• Ensure HIPAA compliance while processing sensitive data.

Skills

Event-driven systems

Node.js

TypeScript

Postgres

Real-time data processing

LLM integration

Job description

Join to apply for the Senior Backend Engineer (Event-Driven Architecture, AI-Enabled Systems) role at Legion Health

Join to apply for the Senior Backend Engineer (Event-Driven Architecture, AI-Enabled Systems) role at Legion Health

This range is provided by Legion Health. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more.

Base pay range

$120,000.00/yr - $180,000.00/yr

• Join us in building the most efficient, AI-powered mental healthcare system.**\ We’re a YC-backed company revolutionizing telepsychiatry—not with AI for diagnostics, but with AI-driven operations that actually make patient care faster, smoother, and more accessible.
  
  

Legion Health | AI-Driven Psychiatric Care – We’re Hiring!

• Join us in building the most efficient, AI-powered mental healthcare system.**\ We’re a YC-backed company revolutionizing telepsychiatry—not with AI for diagnostics, but with AI-driven operations that actually make patient care faster, smoother, and more accessible.
  
  

We’re hiring top-tier engineers who thrive in high-velocity, AI-first environments and want to build technology that meaningfully improves lives. If you love shipping fast, working with AI, and solving hard problems, keep reading.

Why This Role?

• You’ll own the architecture for a next-gen, AI-driven healthcare system.
• You’ll design event-driven systems that integrate LLM-powered automation across scheduling, billing, and patient interactions.
• You’ll scale a backend that supports thousands of patients while maintaining HIPAA compliance & security.
• You’ll shape the future of AI in healthcare, working directly with the founding team.
  
  

What You’ll Work On

• Architecting and implementing a highly-scalable, event-driven backend using Node.js, Supabase (Postgres), and AWS.
• Building real-time, AI-powered patient and provider workflows that optimize scheduling, intake, and operational efficiency.
• Designing robust event pipelines to capture and structure rich operational data (call transcripts, scheduling metadata, etc.).
• Ensuring high availability, reliability, and security—handling PHI data while keeping everything fast and seamless.
• Collaborating with our AI and front-end teams to build an integrated, LLM-powered care delivery system.
  
  

What We’re Looking For

• 5+ years of experience in backend engineering (Node.js, TypeScript, Postgres).
• Expertise in event-driven systems, message queues, or stateful data architectures.
• Experience with real-time data processing (e.g., webhooks, Kafka, or event sourcing).
• Comfortable working with LLMs—you don’t need deep AI expertise, but you should be excited to build AI-first systems.
• Strong security and compliance mindset (HIPAA or other regulated environments is a huge plus).
  
  

What We Offer

• $70-200K salary + 0.2-1.0% equity (commensurate with experience).
• A high-velocity team—you will ship and own your work.
• A mission that matters—we’re solving real healthcare problems at scale.
• Deep AI integration—you’ll be at the frontier of operational AI in healthcare.
  
  

Apply now

Seniority level

• Seniority level

  Mid-Senior level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Engineering and Information Technology

• Industries

  Mental Health Care

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