Founding Backend Engineer
Summary
Founding backend engineer (employee of a 4-person, $100M-funded venture-backed startup) building LLM-powered healthcare billing infrastructure in Hoxton, London. Day to day: owning 0-to-1 data pipelines (Prefect, LakeFS, AWS) and ultra-low-latency APIs that turn policy documents into deterministic clinical rules, using Python and distributed-systems design, on-site 5 days a week.
Founding Backend Engineer | Python & Distributed Systems | LLM-Powered Healthcare Infrastructure
We are seeking an exceptional, backend-leaning Founding Software Engineer to join a high-caliber four-person team building mission-critical infrastructure that makes healthcare billing deterministic. Backed by $100M in committed funding and a landmark design partnership with a $12B industry leader, this is a rare 0-to-1 opportunity to shape the core platform architecture tackling a massive $200B+ market from the ground up.
What You’ll Be Doing:
- Taking complete end-to-end ownership of 0-to-1 platform initiatives, independently identifying high-leverage architectural gaps and shipping scalable production systems.
- Designing and operating high-throughput data pipelines using Prefect, LakeFS, and LLM-powered extraction to turn unstructured policy documents into computable clinical rules.
- Architecting and scaling ultra-low-latency API and MCP endpoints serving deterministic coverage rules to millions and billions of transactions.
- Translating complex domain criteria into formal logic and FHIR queries for automated, deterministic evaluation against clinical data.
- Driving continuous engineering innovation by experimenting with AI-assisted workflows, agentic coding tools, and autonomous pipelines within a lean, high-autonomy team.
What We’re Looking For:
- 2–6 years of commercial backend engineering experience building and scaling production systems at a venture-backed startup (Series A–D).
- Problem-first engineering mindset with strong architectural depth and comfort navigating ambiguity in rapid iterations.
- Strong foundational degree in Computer Science, Mathematics, or Engineering.
- Experience working with modern data engineering tooling, orchestration frameworks, and cloud ecosystems (AWS, Railway, Prefect, LakeFS).
- Passion for cutting-edge developer velocity, modern AI tooling, and agentic workflows.
Must-Haves:
- Deep hands-on production engineering experience in Python (with strong typing frameworks like Pydantic).
- Proven experience building high-scale distributed backend systems; background in lower-level languages (Rust, C/C++) is a strong signal of engineering depth.
- Existing UK Right to Work or a transferable visa (no new visa sponsorship available).
- Full availability to work on-site 5 days a week at the office in Hoxton, London (relocation support available).
Location & Working Setup:
- On-site model: 5 days per week based out of Hoxton, London (relocation support provided if relocating to London).
