Senior Backend Engineer

About Nestmed

Nestmed is redefining home care with AI-driven technology that helps clinicians work more efficiently and provide better patient care. Our field solution handles scribing, scheduling, and documentation in the background, offering real-time clinical support so clinicians can stay focused on their patients—not paperwork.

Every day, thousands of nurses and physical therapists use Nestmed to streamline their workflows, save time, and enhance patient outcomes. In just one year, we’ve become the preferred AI partner for the largest home care EMRs in the U.S., helping shape the future of home healthcare.

Backed by top investors—including SciFi VC (Max Levchin, PayPal co-founder) and Mischief Capital (Plaid founder)—our team includes Stanford and YC alumni, alongside industry veterans dedicated to transforming home care delivery.

About The Role

As a Senior Backend Engineer at Nestmed, you will be responsible for designing, building, and scaling our core platform, which processes thousands (soon tens of thousands) of audio files per day. This system analyzes, correlates, and integrates data into multi-step distributed workflows that power our AI-driven insights and documentation automation.

You will play a critical role in developing backend infrastructure that supports large-scale AI workloads, ensuring high availability, fault tolerance, and seamless integration with electronic medical records (EMRs) and industry partners.

What You’ll Do

• Design, develop, and optimize backend systems for large-scale audio and document processing.
• Build AI-driven algorithms and statistical models that extract insights from clinician interactions.
• Scale cloud infrastructure using Infrastructure-as-Code (IaC) tools on AWS to support growing data volumes and new integrations.
• Develop and maintain highly fault-tolerant distributed systems where reliability and correctness are critical.
• Collaborate with AI, product, and clinical teams to continuously improve the platform’s performance and accuracy.
• Implement best practices for security, scalability, and maintainability in a fast-paced startup environment.
  
  

Who You Are

• Experienced in backend development at scale, with a deep understanding of data processing workflows.
• Proficient in cloud infrastructure (AWS preferred) and IaC tools like Terraform or CloudFormation.
• Strong in algorithm development, AI integration, and statistical methods for data processing.
• Skilled in designing and maintaining distributed systems that require high availability and fault tolerance.
• Comfortable working in a fast-paced, high-ownership environment, where you drive key technical decisions.
• Based in San Francisco and excited to work in-person, contributing to a collaborative, high-energy team culture.
  
  

Why Join Nestmed?

• Build something that matters – Your work will directly impact clinicians and patients by making home care more efficient and effective.
• Take ownership of big projects – We empower engineers to lead key technical initiatives and drive meaningful innovation.
• Join a world-class team – Work alongside experienced professionals from top AI, healthcare, and tech companies.
• Be part of a rapidly growing startup – We’re well-funded, scaling quickly, and providing exciting career growth opportunities.
  
  

Work in a dynamic, in-person environment – We believe in building strong, in-office collaboration at our beautiful San Francisco headquarters.

If you’re passionate about building high-impact products that solve real-world problems, we’d love to hear from you. Apply today!

Compensation Range: $170K - $250K