Commure is a healthcare technology company developing AI-powered software and integrated infrastructure for health systems. Its products include ambient AI assistants, revenue cycle management tools, patient engagement platforms, and asset and safety monitoring solutions that connect with electronic health records. By working with health systems to build and deploy these tools, Commure supports automation across clinical documentation, coding, billing, and operational workflows, with a focus on reducing care costs, easing clinician burnout, and improving patient and organizational outcomes.
Staff Backend Engineer, Ambient AI — Mountain View Hybrid
Lead backend engineering for Commure’s Ambient AI healthcare platform, building dependable distributed systems and inference workflows. Own orchestration, observability, cloud infrastructure, and operational performance for clinical products.
United States
California$210,000 – $275,000 / year
HybridFull-timeLeadEnglish RequiredBackend EngineerSoftware EngineerDescription
- Design, build, and operate backend systems that support Ambient AI products across mobile and web
- Develop inference workflows for transcription, diarization, language models, clinical extraction, summarization, and related AI capabilities
- Create orchestration systems for durable, multi-stage workflows
- Implement scheduling, queueing, prioritization, retries, timeouts, fallbacks, dead-letter handling, idempotency, replay, recovery, model routing, versioning, progress tracking, and graceful degradation
- Strengthen reliability and scalability for variable, compute-intensive workloads
- Define and maintain SLOs covering availability, processing latency, completion rates, and data durability
- Develop observability with structured logs, metrics, distributed tracing, dashboards, alerts, and diagnostic tools
- Lead incident response and conduct post-incident analysis
- Detect recurring system failures and resolve them through better abstractions, automation, testing, and architecture
- Advance cloud infrastructure, deployment systems, capacity planning, and operational tooling
- Design APIs and data models that support safe, predictable interaction with long-running workflows
- Create tools to inspect, test, replay, evaluate, and debug inference pipelines
- Balance reliability, latency, quality, and infrastructure costs
- Collaborate with mobile, product, AI, security, and clinical teams
- Mentor engineers and establish practices for distributed systems, observability, operational readiness, and backend architecture
- Follow information security policies and report confirmed or suspected security events and risks
Requirements
- At least 8 years of professional experience in backend or infrastructure engineering
- Professional experience designing, building, and operating distributed production systems
- Strong proficiency in at least one modern backend programming language
- Experience with asynchronous processing, message queues, event-driven architectures, or durable workflow execution
- Deep understanding of idempotency, consistency, concurrency, backpressure, retries, failure isolation, and eventual completion
- Experience running cloud services, including deployment, monitoring, scaling, and incident response
- Experience designing APIs, service boundaries, and data models for complex product workflows
- Demonstrated success improving reliability, observability, scalability, or operational efficiency
- Strong debugging ability across application, infrastructure, data, and external-dependency boundaries
- Ability to reason about real-time and long-running workloads with differing latency and durability requirements
- Comfort working across backend, infrastructure, product, and AI systems
- Preferred: experience with speech-to-text, diarization, transcription, or audio-based machine-learning workflows
- Preferred: production experience with large language models or multi-model inference pipelines
- Preferred: experience with Temporal or comparable durable execution platforms
- Preferred: experience with Kafka, Pub/Sub, SQS, or similar messaging systems
- Preferred: experience with model routing, inference gateways, rate limiting, batching, caching, or GPU-backed workloads
- Preferred: experience building workflow inspection, replay, evaluation, or model-debugging tools
- Preferred: experience with SLOs, error budgets, alerting, and production incident response
- Preferred: experience with Grafana, OpenTelemetry, Sentry, or comparable observability tools
- Preferred: experience with containers, Kubernetes, infrastructure as code, and cloud-native deployment systems
- Preferred: experience optimizing throughput, tail latency, infrastructure cost, or workload isolation
- Preferred: experience with offline clients, background synchronization, or reconciliation of delayed and duplicated events
- Preferred: experience in healthcare, HIPAA, SOC 2, encryption, privacy, security, or regulated environments
- Preferred: experience with AI-native, real-time, or agentic products
- Must work from the San Francisco or Mountain View, California office at least three days per week
- Must state whether US work sponsorship will be required
Benefits
- Equity compensation
- Opportunity to build an AI healthcare product used in real clinical workflows
- Opportunity to grow into broader backend, infrastructure, or technical leadership responsibilities
- Official company communications are sent exclusively from @commure.com email addresses