Founding Engineer, Backend & Infra

Benefits

Parental leave

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Non-birth-parent leave

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Family-building benefits

• Fertility benefits: Not verified
• Adoption assistance: Not verified
• Surrogacy assistance: Not verified

Mental health support

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Relocation assistance

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Childcare support

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Learning budget

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Verification

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Salary

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401(k) match

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Market context

U.S. role benchmark (BLS OEWS)

$116,543 U.S. median for this role

Projected growth (BLS Employment Projections)

+9.8% - Much faster than average

Matched to SOC 15-1252 - Software Engineering aggregate by role bucket.

Source: U.S. Bureau of Labor Statistics, OEWS, May 2024 and Employment Projections, 2024-2034.

Role

Role function

Engineering From the posting source checked Jun 20, 2026

Seniority

Mid From the posting source checked Jun 20, 2026

Schedule

Shift type

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Weekend work

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Company

Company stage

Early From the posting source checked Jun 20, 2026

Application

Cover letter

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Assessment

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Deadline

Not stated

Where they hire

State eligibility is not yet verified.

About this role

Founding Engineer, Backend & Infra San Francisco, California, United States Founding Engineer, Backend & Infrastructure About Backbone Care should be paid for the moment it's delivered. At Backbone, we're making that possible for the first time by building the clinical AI layer for healthcare payments. Today, U.S. healthcare wastes more than $350B yearly on administrative work that has nothing to do with patient care: prior authorizations, denials, appeals, and the staff hired on both sides of the aisle to adjudicate and determine payment for services rendered. As a result, patient care is delayed, clinicians burn out, margins crater, and hundreds of billions of dollars that should be funding care end up funding the friction itself. Backbone is dismantling this friction, building intelligent financial rails atop clinical AI research to facilitate instant payments between payers and providers. We're backed by Andreessen Horowitz (a16z), Lightspeed, Hanabi, and a roster of operators and clinicians who have built and run the largest payers, providers, and healthcare technology platforms in the country. Our founder/CEO, Manan Shah, holds a BS/MS in Math & CS from Stanford and led ML infrastructure at Sequoia-backed Kumo AI, where he built graph neural networks serving DoorDash, Reddit, and Coinbase. Backbone's revenue is growing quickly, customer demand is outpacing our team, and the road ahead is bright. What you'll do As a founding engineer, you'll own the systems that make Backbone work: chart ingestion, document processing, claims workflows, browser and computer-use automation, payer portal navigation, orchestration, queues, reliability, auditability, and the

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