{"id":731811,"url":"https://alion.io/job/clarionhealth-senior-backend-engineer","title":"Senior Backend Engineer","company":{"id":673580,"name":"Clarion Health","domain":"clarionhealth.com","url":"https://alion.io/company/clarionhealth","size_band":"51-200","is_staffing_agency":false,"employer_type":"direct","is_intermediary":false,"listed_via":null,"ats_vendor":"Ashby","truth_index":{"grade":"B","score":78,"open_postings":8,"ghost_share":0,"stale_share":0.875,"repost_share":0,"time_to_fill_p50_days":null,"computed_at":"2026-10-23T05:54:15Z"}},"role":"Backend","role_family":"Backend","seniority":"senior","employment_type":"full_time","work_mode":"on_site","remote_scope":null,"remote_scope_basis":null,"remote_working_hours":null,"hiring_geo_confidence":"structured","locations":["New York, United States"],"countries":["US"],"hiring_countries":[],"hiring_countries_total":0,"salary":{"min":150000,"max":225000,"currency":"USD","period":"year","gross":null,"usd_annual":225000},"salary_estimate":null,"experience_years_min":5,"visa_sponsorship":false,"relocation_package":false,"has_equity":false,"technologies":[{"name":"Agentic Workflows","optional":false},{"name":"AI Agents","optional":false},{"name":"HIPAA","optional":false}],"status":"live","first_seen_at":"2026-02-16T19:30:16Z","employer_posted_date":"2026-02-16","last_verified_at":"2026-10-23T14:44:59Z","board_verified":true,"closed_at":null,"days_open":248,"trust":{"level":"stale","repost_count":0,"flags":["stale"],"days_open":248},"description":"About Clarion\nAt Clarion, we’re rebuilding how healthcare communicates in the age of AI.\nToday, clinics miss 30-40% of patient calls, while staff are overwhelmed by administrative work. We believe AI agents should handle these workflows-scheduling, billing, prescription refills, and follow-ups-so healthcare teams can focus on actual patient care.\nWe’re building the communication infrastructure modern healthcare needs. Our AI agents don’t just answer calls-they complete workflows end-to-end, ensuring patients never go unheard. To date, we’ve handled hundreds of thousands of patient interactions across virtual care companies, health systems, and a $5B health insurance company.\nClarion was founded by a Stanford/Harvard-trained physician (founding team at Two Chairs and Ophelia) and an ex-Amazon Alexa engineer who led AI/ML teams at Salesforce. We’ve raised $10M from Accel, Y Combinator, Sequoia (Scout), and leading healthcare founders. We’re an in-person team in New York, moving fast to solve one of healthcare’s most critical problems.\nWhy This Role Is Special\nReal traction, early-stage impact: Dozens of paying customers, rapidly growing revenue, and the opportunity to own foundational backend systems at a critical inflection point.\n\nMission-critical problem: Healthcare communication failures affect millions daily-your work directly powers systems patients and providers rely on.\n\nElite technical context: Work closely with founders who deeply understand both healthcare operations and large-scale AI systems, enabling fast decisions and real ownership.\n\nWhat You’ll Own\nCore backend systems: Design, build, and own the services, data models, and business logic powering Clarion’s AI agents and healthcare workflows.\n\nWorkflow orchestration: Build infrastructure for multi-step, asynchronous workflows-including agentic AI workflows with conditional logic, retries, and graceful failure handling.\n\nHealthcare integrations: Own high-stakes integrations with EHRs and legacy healthcare platforms via APIs and RPA.\n\nPlatform foundations: Create internal abstractions and tooling that allow the team to deploy and customize AI assistants for new customers quickly and reliably.\n\nSecurity and compliance: Implement and maintain backend authentication, authorization, and HIPAA-compliant architecture required for enterprise healthcare.\n\nInteresting Technical Challenges\nGenerative AI at Scale: Design and operate production systems using LLMs with real-time monitoring, safety controls, and enterprise reliability.\n\nAgentic workflows: Architect backend systems that coordinate AI agents across complex healthcare workflows with strong guarantees.\n\nEnterprise reliability: Build systems supporting thousands of concurrent patient interactions with high uptime and fast incident detection.\n\nFragmented healthcare systems: Design resilient abstractions across modern APIs and legacy EHRs while maintaining security and compliance.\n\nWhat We’re Looking For\n5+ years of experience designing, building, and scaling backend systems in high-reliability production environments.\n\nStrong backend expertise across APIs, relational databases, async workflows, and distributed systems.\n\nHigh ownership and agency-you thrive in ambiguity and take responsibility for system outcomes.\n\nAbility to communicate clearly, collaborate cross-functionally, and surface risks early.\n\nBonus: experience with security, auth, or regulated environments (HIPAA familiarity is a plus).\n\nYou’ll be a great fit if you enjoy owning critical backend systems end-to-end, solving complex problems under real-world constraints, and building infrastructure that directly impacts patient care.\nInterview Process\nWe move quickly and communicate clearly at every stage:\nIntro Chat (30 min, Virtual): Background, role context, and mutual fit.\n\nTechnical Deep Dive (1 hr, Virtual): Backend systems and architecture with the CTO and a senior engineer.\n\nOnsite Team Day (Half Day, NYC): Collaborate on real problems, present a past project, meet the team, and assess mutual fit.\n\nDecisions are typically made within 24 hours of each stage.","description_format":"text","description_chars":4107,"description_truncated":false,"requirements":{"experience_years_min":5,"management_years_min":null,"team_size_min":null,"manages_managers":false,"education":null,"security_clearance":false,"languages":[]},"benefits":["Health insurance"],"hiring_locations":[],"hiring_excludes":[],"relocation_offered":false,"industries":["AI Agents","Patient Access & Booking"],"lifecycle":[{"event":"open","at":"2026-09-11T09:57:11Z"},{"event":"open","at":"2026-09-26T09:20:36Z"}],"visa":[],"liveness":{"score":8,"band":"cold","label":"Long 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