We are seeking a highly experienced Technical Lead/Principal Backend Engineer to help build the technical foundation for a next-generation healthcare platform. This is a hands-on leadership role with significant ownership, where you will define the platform architecture, establish engineering best practices, and build scalable, secure integration layers connecting critical healthcare and business systems. The ideal candidate has deep backend engineering expertise, experience designing API-first distributed systems, and a strong background in regulated healthcare or HIPAA-compliant environments. This role is best suited for someone who thrives in fast-paced startup environments and enjoys building platforms that will support future product growth, AI-enabled capabilities, analytics, and digital patient experiences.

Key Responsibilities

Define and own the overall platform architecture for a modern healthcare platform. Lead the design and implementation of the integration and service layer connecting systems such as Healthie (EHR), Evexia (labs), Shopify, Thinkific, and GoHighLevel. Establish engineering best practices, including CI/CD pipelines, release management, and scalable development processes. Design secure, scalable, API-first backend systems and distributed architectures. Build the technical foundation for future patient portals, internal workflows, AI-enabled features, analytics, and product expansion. Collaborate across teams to ensure the platform can support additional healthcare systems and integrations over time. Provide technical leadership while remaining deeply involved in hands-on development.

Core Requirements

10+ years of professional software engineering experience, including extensive backend development. Proven technical leadership building modern web platforms. Experience building secure, scalable systems within healthcare or other HIPAA-regulated environments. Deep expertise in API-first architecture, distributed systems, and third-party integrations. Experience with EHRs, patient portals, healthcare workflows, or other regulated healthcare technologies. Strong experience establishing engineering best practices, CI/CD pipelines, and release management processes. Strong backend development experience with two or more modern technologies such as Python, TypeScript/Node.js (NestJS), Go, Ruby on Rails, or similar. Experience with relational and/or NoSQL databases, including PostgreSQL, MySQL, Redis, or MongoDB. Experience designing and deploying secure cloud infrastructure using AWS and/or GCP. Comfortable working in fast-moving, ambiguous startup environments. Experience leveraging AI tools to improve engineering productivity and effectiveness. Excellent written and verbal communication skills in English. Ability to work independently in a remote, fast-paced environment.

Nice-to-Have

Experience with the Shopify ecosystem. Experience building healthcare integrations or middleware platforms. Experience designing internal service layers or integration platforms connecting multiple SaaS products. Experience building scalable platforms that support multiple products and engineering teams. Experience with authentication, SSO, and identity architecture in regulated environments. Experience with event-driven architectures, messaging systems, or workflow orchestration. Experience working in modern monorepo environments (e.g., Nx or Turborepo). Experience with Infrastructure as Code (Terraform or similar).

Additional

US Timezone Overlap: Required

Why Join Kake? Kake is a remote-first company with a global community, fully believing that it’s not where your table is, but what you bring to the table that matters. We provide top-tier engineering teams to support some of the world’s most innovative companies, and we’ve built a culture where great people stay, grow, and thrive. We’re proud to be more than just a stop along the way in your career - we’re the destination. The icing on the Kake:

The icing on the Kake: 💵 Competitive Pay in USD – Work globally, get paid globally. 🏡 Fully Remote – Simply put, we trust you. 🌱 Better Me Fund – We invest in your personal growth and passions. ❤️ Compassion is Badass – Join a community that invests in social good.

Please Note: Due to the high volume of applications, only shortlisted candidates will be contacted.