Senior Backend Engineer – Global Healthtech (.NET / C#)
Senior Backend Engineer – Healthtech (.NET / C#)
Remote (South Africa) | Full-Time | Salary Package: R100,000 – R115,000 per month
Includes: base salary, employer retirement contribution, monthly medical aid contribution
About the Company
Our client is a European healthtech startup building modern practice management software for healthcare professionals. They are building modern, intuitive practice management software that reduces administrative burden for medical professionals and enables deeper system-wide healthcare integration.
If you’ve ever used outdated legacy medical software and thought “there must be a better way,” this is the team making it happen. Their mission: enable better healthcare experiences through thoughtful technology. They operate with strong values of ownership, excellence, integrity, and collaboration, and their lean, product-driven team focuses on building software used by healthcare professionals
The Role
We are looking for a Senior Backend Engineer (.NET / C#) to take a high-ownership role within a cross-functional product team.
You will build the core services layer of a sophisticated cross-platform application, designing secure, scalable, and maintainable backend systems that directly support healthcare delivery. This role goes beyond coding, it requires architectural input, mentoring teammates, and shaping the long-term technical direction of the platform.
What You’ll Be Responsible For
Designing and building APIs for frontend applications and external integrations
Managing complex, structured, and sensitive healthcare data
Contributing to architectural decisions grounded in Domain-Driven Design (DDD) and SOLID principles
Collaborating daily with Product Owners, UX/UI Designers, QA, and DevOps
Refining requirements, planning user stories, and estimating delivery
Conducting code reviews and mentoring team members
Continuously improving code quality, architecture, and engineering processes
Required Experience and Skills
8+ years of backend engineering experience
Expert-level proficiency in C# and .NET Core
Strong experience with ASP.NET and Entity Framework Core
Solid experience with relational databases (PostgreSQL preferred)
Strong Git experience in collaborative environments (branching, merge requests, conflict resolution)
Experience in cross-functional Agile (Scrum) teams
Comfortable with pair programming and code reviews
Strong written and verbal English communication skills
Nice to Have
Experience in regulated industries (healthcare strongly preferred)
Familiarity with DDD and CQRS
API-first and RESTful design experience
Automated testing experience (TDD/BDD)
Knowledge of FHIR and HL7 standards
Strong PostgreSQL expertise
GitLab CI/CD experience
Docker experience
General understanding of frontend fundamentals
Who This Role Is For
Self-starters who can operate independently and own mission-critical systems
Engineers who thrive in lean, high-accountability environments
Individuals who care deeply about code quality and product impact
Tech Stack
C#, .NET Core, ASP.NET, EF Core, PostgreSQL, Git, GitLab, Docker, Visual Studio / Rider
About Project Y
This role is recruited by Project Y, a recruitment agency connecting South African tech talent with global opportunities. Applications will be managed through Project Y.
Skills
As published by recruitee · 13 questions · 7 written answers
Basics
Full name, Email, CV, Cover letter, Phone
Short answers (3)
- What are your current monthly salary expectations (ZAR)?
- What is your current notice period or availability to start?
- Please record a 1–2 minute video introducing yourself, your background, and why you are interested in this role.
Pick from a list (3)
- Are you based in South Africa and legally eligible to work full-time here?
- How many years of backend development experience do you have?
- Which of the following technologies do you have hands-on experience with? (Select all that apply)
Written answers (7)
- Describe a backend system you’ve designed or significantly contributed to. What architectural choices did you make, and why? How did you ensure scalability, maintainability, and security?
- Tell us about a time you worked in a cross-functional team (backend, frontend, QA, PO, UX) to deliver a product. How did you handle disagreements or conflicting priorities?
- Have you worked in regulated industries (healthcare, finance, etc.)? If yes, what was your experience handling sensitive or structured data?
- What motivates you most as a developer: working on challenging problems, driving product impact, mentoring teammates, or other? Please explain briefly.
- This role requires ownership over mission-critical backend systems. Can you give an example of a time you took full ownership of a feature or system? What challenges did you face, and how did you overcome them?
- How would your previous colleagues describe working with you? What strengths and areas for improvement would they highlight?
- How do you approach code quality, testing, and maintaining long-term system reliability? Give examples from your experience.