Senior Software Engineer, Backend at Axle Health

ABOUT US Axle Health builds AI scheduling and workforce management software to empower in-home healthcare providers to deliver exceptional, personalized care right where patients feel most comfortable—at home. Some of the biggest providers in the country use our software (like Cityblock Health and U Penn Health System) to improve the utilization of their field teams by 17%+, and automate the operational burden of scheduling and dispatching. Our platform includes proprietary logistics algorithms to optimize scheduling, a mobile app for field staff, an operations dashboard for office teams, engagement and booking tools for patients, and a wide range of integrations and external APIs for modular access. We’re a team of top-tier engineers and operators, backed by $14m from top investors such as Y Combinator, Pear VC, and F-Prime, applying our intellect and logistics experience to upend how home healthcare is delivered. ABOUT YOU We're looking for a Senior Software Engineer to join our Platform Engineering team; the group responsible for the core backend systems and infrastructure that power Axle Health's scheduling and workforce management platform. This is a foundational role: you'll design and build the platform capabilities that every other team builds on, with a direct impact on reliability, performance, and developer experience across engineering. Our ideal candidate brings deep backend expertise, strong instincts for system design, and a track record of owning platform-level problems end to end. You care about doing things right (not just shipping) and you bring the same rigor to API design, observability, and security as you do to core feature work. Whether you've built web-scale infrastructure at a growth stage company or scaled a startup's platform from the ground up, we want to hear from you. WHAT YOU’LL DO - Design and develop platform capabilities that enable integrations with Electronic Health Record (EHR) and Electronic Medical Record (EMR) systems and power Axle Health's broader ecosystem - Architect high-volume backend systems built to support hundreds of thousands of patients reliably and at scale - Lead efforts to optimize service orchestration, data flow, and system performance across the platform - Drive high standards for security, testability, observability, and deployment automation across platform services - Design and maintain modern, developer-friendly APIs and documentation - Collaborate with and provide technical leadership to other engineers, setting a high bar through rigorous code reviews and architectural guidance - Write clear documentation to scale platform knowledge within the team and across engineering REQUIREMENTS - Bachelor's degree - 7+ years of profession software engineering experience - Expertise building backend systems in multiple languages, demonstrated ability to pick up multiple backend focused languages and frameworks - Hands-on experience designing relational database schemas and migrations with a focus on scalability, extensibility, performance, and stability - Experience managing customer-facing APIs through versioning and deprecation cycles - Proven ability to diagnose and fix performance bottlenecks in database-backed applications - Working knowledge of CI/CD, DevOps practices, and build systems - Strong technical communication skills (able to explain complex decisions clearly to both technical and non-technical stakeholders) - Experience working in fast-paced, high-growth startup environments with a track record of operating with significant autonomy NICE TO HAVES - Experience working with Electronic Health Records (EHRs) and/or healthcare interoperability standards (FHIR, HL7) - Experience building systems managing HIPAA compliant data or similar compliance-driven industries with data security requirements - Experience building scalable, observable distributed systems - Experience building ETL pipelines that extract from multiple source systems and load into cloud-based data warehouses (e.g., Snowflake, Redshift, BigQuery) to support analytics and reporting needs - Familiarity with the Axle Health tech stack: Django, GraphQL, PostgreSQL, AWS, Datadog TOOLS YOU WILL USE - Django + Python 3 - Node + Typescript - GraphQL - PostgresSQL - AWS - Datadog for monitoring and observability - Git / Github / Graphite - Claude Code and Cursor WHAT WE OFFER In addition to offering a competitive salary and equity, we want to ensure every team member has the tools they need to work to the best of their ability. To that end… We are committed to your Ownership: - We cultivate an environment where team members feel ownership over the work they do. Everyone in an organization has big ideas and we want to hear them and implement them. - All of our employees have equity compensation. We want you to benefit from all the hard work you do in helping patients and catalyzing this shift in healthcare. We are committed to your Wellness: - Medical, Dental, Vision - 401k plan - Flexible PTO and sick days - Commuter benefits - Santa Monica HQ with 180 degree beach views and daily catered lunches We are committed to your Growth: - Fast paced work environment geared towards professional growth - Get the chance to move roles within the organization to learn new skills and continue to make an impact We are committed to building Community: - Monthly team events, dinners, & happy hours - Special team outings - some past events have included: yacht cruises, visits to Universal Studios, Magic Castle, and Vegas