San Francisco, CA

Salary
$200,000–$230,000from the description
Posted
Jul 20, 2026
Location
San Francisco, CA
Last confirmed open
Jul 21, 2026

What this job asks for AI summary

A staff-level backend engineering role on a small founding team building a virtual care platform for seniors. The work centers on designing core architecture, integrating healthcare systems (EHRs, billing, care management tools), and establishing engineering practices from the ground up. It suits a seasoned backend engineer — strong in Ruby or Python with Elixir experience — who is comfortable making broad technical decisions with limited process and close proximity to business strategy.

Staff level · 9+ years · San Francisco-Oakland-Berkeley, CA · Full-time

Must have (4)
Ruby or PythonElixir · 2+ yrsdistributed systemsREST
Nice to have (6)
FHIRHL7X12Phoenix LiveViewEHR integrationsHIPAA

“or” means any one of them counts — you don't need all of them.

We read this from the posting text with AI. Skim the description below before ruling yourself out.

How this req sits in the market our data

Roughly 100 people in the San Francisco-Oakland-Berkeley, CA area plausibly meet what this posting asks for (software developers). range 60–150

Applicant volume Moderate — A normal amount of company. The rare requirements below are what will separate a shortlisted application from the rest.

What gives you an edge
Elixir4%

Rare in this occupation — lead with these, and say what you built with them.

What won't set you apart
Ruby51%

Most people in this occupation already list these. Still required — just not what gets you shortlisted.

What the occupation pays Median $190,744 (middle half $167,095–$224,501). This posting is about at that midpoint.

Estimated from BLS employment for this occupation and area, per-skill prevalence across our listing corpus, and published wage benchmarks — as of Jul 28, 2026. It is a model, not a headcount.

Why we read it this way (6)

Ruby and Python are listed as interchangeable — the JD states 'Expert-level proficiency in Ruby or Python'; Ruby is listed first and is closer to Elixir in the stack context, so it is used as the primary with Python as the alternative.

Elixir is explicitly required with a hard minimum of 2+ years of hands-on professional experience under Minimum Qualifications; the JD also notes the team builds in Elixir.

FHIR, HL7, X12, Phoenix LiveView, EHR integrations, and HIPAA experience all appear under Preferred Qualifications and are marked accordingly.

The role is hybrid (2–3 days/week in-office in San Francisco) and is not fully remote.

This role is genuinely Staff-level: the JD explicitly titles it 'Staff Backend Software Engineer', and the scope — second engineer, owning technical architecture, partnering with the GM as a technical co-founder analog, setting engineering practices — supports that band independently of the 9+ years requirement.

No formal degree is stated as required; the compensation section mentions education as one factor in determining actual pay but does not gate the role on a specific degree.

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