Sr. Backend Engineer

Healthcare is broken at the first step: patients can't find the right care, understand what it costs, or access the medications they need. Mochi Health is fixing this. We're building an AI-driven marketplace that makes healthcare discoverable—connecting patients to the right providers, transparent pharmacy pricing, and affordable medications. Over the past few years, we've grown rapidly by combining clinical expertise with technology that actually works for real people, not just hospital systems. Our platform does what legacy healthcare can't: it gives patients transparent pricing before they pay, personalized medication management that follows them across providers, and long-term access to their own medical records. We're proving that healthcare can be more affordable, more human, and far more intuitive than what exists today. Join a team that's rebuilding healthcare from the patient up. At Mochi Health, you'll work alongside people who value bold thinking, inclusive collaboration, and getting meaningful work into the world. If you want to do the most impactful work of your career, this is where to do it. $230,000 - $280,000 (Open to Staff leveling at $280-330K) Full-time / Onsite (5 days/week) About The Role At Mochi, our engineering team operates with exceptional leverage. We believe in high talent density, where a focused, elite team powers a profitable, nine-figure ARR healthcare platform serving hundreds of thousands of patients. We are looking for a Senior Backend Engineer to own the core systems that power this scale—from clinical approval workflows and multi-pharmacy fulfillment routing, to complex subscription billing and partner integrations. Mochi has already helped patients lose over 5 million pounds through metabolic care, and we are now rapidly expanding into the frontiers of preventative healthcare—including hormone optimization (HRT/TRT), longevity medicine, and cutting-edge peptide therapies. The backend systems you architect will power how this next wave of patients discovers treatments, qualifies for care, and receives highly personalized, dynamic dosing protocols. Because of our high scale-to-team ratio, we do not operate in isolated technical silos. You will own your systems end-to-end: designing the schema, writing the business logic, deploying to Kubernetes, and owning the observability in production. If you are drawn to architectural problems where the domain complexity is real, the autonomy is absolute, and the impact on patient outcomes is tangible, this is the role. What You’ll Do Architect Healthcare Commerce: Build and evolve a subscription and billing infrastructure that handles the messy reality of healthcare. You will solve for mid-cycle medication switches, dynamic pricing across different pharmacy partners, payment recovery, and prorated billing. Build Clinical State Machines: Own the systems that power complex medication ordering and fulfillment. You will build highly reliable pipelines that handle compounding pharmacy integrations, controlled substance compliance, and personalized dosing protocols across a distributed network of external partners. Own the Infrastructure: Take hands-on ownership of the AWS and Kubernetes infrastructure that runs your services. You will establish CI/CD pipelines, build observability, and create deployment patterns that make it safe for the entire team to ship rapidly. Act as a Product Partner: Work directly with Clinical, Operations, and Product teams to shape what we build. You will evaluate proposed workflows, take ownership of business outcomes, and actively identify paths to deliver maximum patient value with highly efficient implementation. Build Agentic Workflows: Mochi is an AI-first engineering org. You will not only utilize frontier agentic models to accelerate your own development, but you will also design the backend architecture that allows AI-assisted agents to automate clinical operations, improve patient safety, and scale ou ... (truncated, view full listing at source)