Principal Backend Engineer, Health Intelligence Platform

Prime Health Technologies is redefining healthcare from reactive to proactive by building the world’s first AI-driven Precision Health Operating System for governments and insurers. Our platform integrates biometric data, behavioral patterns, and intelligent reasoning to deliver personalized, preventative care at national scale. We partner with governments and insurers to improve population health outcomes, reduce healthcare costs, and empower every citizen with a personal AI health companion that adapts daily by guiding movement, nutrition, sleep, and lifestyle. This is not a wellness app. This is national health infrastructure. At the center of our platform is ELIA, an intelligent system that powers closed-loop health optimization across individuals, populations, and policy decision-makers through continuous sensing, reasoning, guidance, and reinforcement. Role Summary We are seeking a Founding Backend Lead to architect, build, and own the backend systems powering the Prime Health platform and ELIA. This role begins as a deeply hands-on technical builder and evolves into a senior technical leadership position and grow the team as the platform scales across governments, insurers, and regions globally. You will work directly with the Chief AI and Systems Architect to establish the core backend foundation for the personalized health companion, the Government Health Command Center, and the AI Reasoning Engine that enables population-scale insights and adaptive feedback loops. This role owns the integrity, scalability, and trustworthiness of the data layer that powers individual personalization and national health decision-making. You will be responsible for ensuring ELIA can reason reliably across millions of users, jurisdictions, and regulatory environments while maintaining privacy, compliance, and system coherence. Key Responsibilities 1. Backend Development and Ownership Team management is part of the job. You will design and build core backend services using Kubernetes, Python and FastAPI to support: • Health data ingestion pipelines including Apple HealthKit, Google Health Connect, wearables, and digital diagnostics • Secure authentication and authorization using Auth0 or Supabase • APIs supporting mobile applications and AI-driven personalization • Secure REST and GraphQL endpoints for React-based administrative and government dashboards You will design modular, extensible data schemas to support: • Behavioral and biometric signal processing • Longitudinal health tracking and scoring systems • Goal tracking, adaptive recommendations, and closed-loop feedback • Temporal reasoning across daily, weekly, and long-term health data You will make architectural tradeoffs between speed, cost, latency, regulatory constraints, and long-term maintainability in production systems. 2. System Architecture and DevOps You will architect a secure, scalable, and multi-cloud-ready backend capable of regional and sovereign deployments. Responsibilities include: • Kubernetes deployment on multiple cloud infrastructure experience is required (AWS, Azure), with Oracle Cloud as a nice-to-have • Designing systems that function in constrained or sovereign cloud environments common in public sector deployments • Defining Infrastructure-as-Code using Terraform and Helm • Implementing baseline observability and instrumentation using tools such as Open Telemetry, end to end observability, and App analytics • Ensuring compliance with HIPAA, GDPR, ISO 27001, ISO 47001 and regional data residency and privacy regulations • Working closely with the AI team to ensure a tight fit with backend services You will be accountable for production reliability, fault tolerance, and operational clarity. 3. Technical Leadership and Decision Authority You will serve as a senior technical leader, team leader and backend owner for the platform. This includes: • Translating system architecture and product specifications into executable milestones and deliverables • Establishing backend coding standards, API conventions, documentation practices, and CI/CD pipelines • Acting as a final technical decision-maker on backend architecture and data system design • Hiring, mentoring, and technically evaluating future backend and team engineers as the team scales • Participating in system design reviews to ensure forward compatibility, modular growth, and architectural discipline 4. Infrastructure and Data Systems You will design and operate hybrid data architectures that support both real-time personalization and population-level analytics. This includes: • PostgreSQL for relational data and system integrity • NoSQL databases such as MongoDB for flexible and evolving data models • Vector databases such as Milvus or Pinecone for semantic search and AI reasoning • Data ingestion and orchestration pipelines using tools such as Airbyte, Prefect, or Temporal You will design data systems that explicitly support longitudinal analysis, temporal reasoning, feature generation, and adaptive feedback loops. You will implement granular data governance, consent-driven encryption, and role-based access controls aligned with privacy-by-design principles. Required Qualifications • 8 or more years of backend or full-stack engineering experience • At least 4 years operating in a senior or technical & team leadership capacity • Actual design skills rather than a “code it up and refactor it later” approach • Expert-level proficiency in Python with FastAPI or Flask • Strong experience designing asynchronous, API-driven systems • Hands-on experience with Kubernetes, AWS, Azure and/or other cloud services including Virtual Private Cloud, Storage, databases, security and managed Kubernetes services • Proven experience designing and scaling secure, high-compliance backend systems • Strong understanding of ETL pipelines, data orchestration, and microservice communication • Solid foundation in database design, data modeling, and schema evolution • Hands-on DevOps experience with CI/CD pipelines, Docker, Kubernetes, and monitoring systems • Experience operating, debugging, and improving production systems under real-world load or regulatory scrutiny • Familiarity with privacy-by-design principles and data protection frameworks • Preferred Experience • Prior experience in healthtech, wearables, biometrics, or digital diagnostics • Experience working with longitudinal, time-series health, behavioral, or physiological data • Knowledge of healthcare data standards such as FHIR, HL7, SNOMED CT, and LOINC • Experience with LLM-based APIs, semantic search, or AI orchestration tools such as LangChain or LlamaIndex • Exposure to agentic AI systems, MCP concepts, or autonomous workflow design • Working knowledge of React-based web applications • Experience supporting multi-tenant, regionally isolated deployments with strong data sovereignty requirements • Familiarity with spec-driven development and strong documentation practices Soft Skills and Working Style • Systems-level thinker with strong architectural intuition • Bias toward clarity, structure, and proactive problem-solving • Comfortable operating in early-stage environments with evolving requirements while maintaining architectural discipline • Strong communicator who can collaborate effectively across product, AI, science, and leadership teams • Strong team skills and able to work with geographically distributed, remote teams • High ownership mindset with a preference for accountability over ambiguity What You Will Build In this role, you will: • Own and evolve the core backend architecture for a global precision health platform • Deliver the first privacy-compliant, cross-region deployment of ELIA for governments and insurers • Establish the technical foundation for agentic personalization, adaptive health guidance, and population analytics • Define the standards, practices, and culture of backend excellence for the engineering organization How to Apply To demonstrate that you read and understand this role, please email [email protected] with the subject line: Closed-Loop Architect – Your Name. In the body of the email answer the following question “Describe one decision you would delay until later when building ELIA, and one decision you believe must be made correctly on day one. Explain why.” Historically, over 95 percent of applicants skip this step. Completing it meaningfully is part of the evaluation. Looking forward to hopefully working with you Apply tot his job