Senior Backend Engineer

Arbiter is the AI-powered care orchestration system that unites healthcare. We are launching our best-in-class, patient-facing Agentic platform to optimize patient outcomes through a unique multimodal approach. We optimize complex healthcare workflows that interface with patients using the latest Agentic AI approaches, and we combine it with a sophisticated platform to serve this Agentic layer at scale. We are looking for expert engineers and leads to join our team and help us push the frontier of what's possible with Agentic workflows in Healthcare.

Backed by one of the largest seed rounds in health tech history and operators who bring the expertise and distribution to scale nationally, we're building the connected infrastructure healthcare should have had all along.

We are a high-performing group of engineers dedicated to delivering innovative, high-quality solutions to our clients and business partners. We believe in:

As a Senior Backend Engineer, you will engineer production agentic systems that directly serve hundreds of thousands of users at scale. Think forward-deployed engineering: you take powerful platform capabilities, design multi-step workflows that orchestrate voice, SMS, video, and web interactions, and ship them to production where real outcomes are measured.

The problems are genuinely hard. You're building systems that navigate complex conversations in multiple mediums, handle sensitive nuances and edge cases in multiple languages, coordinate multi-outcome workflows across departments, and adapt dynamically based on user responses. You will innovate on how agentic technologies can be pushed to their maximum potential, not follow a playbook.

Roughly 60-70% of your time is deployment-focused. The remainder is platform contribution: building reusable workflow primitives, improving shared infrastructure based on patterns you see across customers, and shaping how we architect agentic systems at scale. Your field experience makes you one of the most valuable voices in platform decisions.

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• 5+ years of hands-on experience building and operating production software systems. Recent experience with AI-powered services, automation, or workflow systems is a strong plus.

• Computer Science or Engineering degree, or equivalent practical experience.

• Strong software engineering fundamentals: you write clean, testable, well-structured code and care about the systems you build.

• Python proficiency (our primary backend language).

• Proficiency with AI-assisted development tools (e.g., Cursor, Claude Code, GitHub Copilot).

• Experience with real-time integrations (APIs, webhooks, bidirectional data sync) in production.

• Experience working across the stack when needed. You're primarily backend-focused but not afraid to touch whatever layer the problem requires.

• Experience with cloud infrastructure (AWS, GCP, or Azure) and production deployments.

• Comfort with ambiguity. You can take a loosely defined problem, structure it, and drive it to a shipped solution without heavy hand-holding.

• Strong communication skills. You will regularly interface with non-technical stakeholders and need to explain technical tradeoffs clearly.

• Experience building agentic workflows, including orchestration across tools and services, multi-step automation, or human-in-the-loop patterns.

• Experience integrating LLM APIs and working with prompt engineering and evaluation.

• Track record of working directly with customers or end users and translating their needs into technical solutions.

• Startup or early-stage experience operating in fast-moving, high-ambiguity environments.

This role can be remote or on-site, based in our New York City or Boca Raton offices, in a fast-paced, collaborative environment where great ideas move quickly from whiteboard to production.