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Dodo Verified
Telecommunications, Energy Retail, Internet Service Provider (ISP)

Senior Backend Developer (NodeJS)

San Francisco, California, United StatesRemoteFull TimeSenior$80,000–$160,000 /yrPosted 2 months agoHidden Gem · YC Startup

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Role summary

We are seeking a Senior Backend Developer with expertise in Node.js and TypeScript to join a small, ambitious team. You will be responsible for architecting and building scalable backend services, designing and integrating APIs (RESTful and GraphQL), and developing real-time voice AI systems. The role involves working with multi-agent AI systems, LLMs, and optimizing infrastructure on GCP using Kubernetes and CI/CD pipelines. Experience in healthcare software or deep real-time systems expertise is preferred. This is a hybrid role requiring a startup mindset.

We’re a reimagining how specialty clinics operate through advanced voice AI and multi-agent systems. Our platform powers intelligent, real-time phone and SMS conversations for healthcare, blending state-of-the-art AI with secure, scalable backend infrastructure. Join a small, ambitious team where your work directly shapes the future of patient engagement and care delivery.\
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**What You’ll Do**

* Architect and build scalable backend services in Node.js and TypeScript


* Design and integrate RESTful and GraphQL APIs (internal and third-party)


* Develop and optimize real-time voice AI systems, including telephony (Twilio, WebRTC) and conversational agents


* Contribute to the design and implementation of multi-agent AI systems for complex, stateful healthcare workflows


* Work with LLMs and help shape our AI engineering frameworks (tool calling, retrieval, orchestration)


* Optimize deployments and infrastructure on GCP (Kubernetes, containers)


* Improve CI/CD pipelines (Cloud Build, GitHub Actions)


* Collaborate with frontend, product, and AI teams to ship features fast


* Champion best practices for performance, scalability, and security

**What We’re Looking For**

* 5+ years of backend experience with Node.js and TypeScript


* 3+ years building real-time communication systems (WebRTC, WebSockets, or telephony)


* Experience with voice AI, conversational agents, or multi-agent system architectures


* Experience in healthcare software (HIPAA compliance) **or** deep real-time systems expertise (both is a plus)


* Startup mindset: You thrive in fast-paced, high-ownership environments
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