{"id":1940779,"url":"https://alion.io/job/commure-staff-backend-engineer-ambient-ai","title":"Staff Backend Engineer, Ambient AI","company":{"id":7685,"name":"Commure","domain":"commure.com","url":"https://alion.io/company/commure","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":83,"open_postings":14,"ghost_share":0,"stale_share":0.643,"repost_share":0.071,"time_to_fill_p50_days":42,"computed_at":"2026-10-20T05:45:00Z"}},"role":"Backend","role_family":"Backend","seniority":"staff","employment_type":"full_time","work_mode":"hybrid","remote_scope":null,"remote_scope_basis":null,"remote_working_hours":null,"hiring_geo_confidence":"structured","locations":["Mountain View, United States","San Francisco, United States"],"countries":["US"],"hiring_countries":[],"hiring_countries_total":0,"salary":{"min":210000,"max":275000,"currency":"USD","period":"year","gross":null,"usd_annual":275000},"salary_estimate":null,"experience_years_min":8,"visa_sponsorship":false,"relocation_package":false,"has_equity":false,"technologies":[{"name":"NLP","optional":false},{"name":"AI Agents","optional":true},{"name":"Apache Kafka","optional":true},{"name":"Grafana","optional":true},{"name":"HIPAA","optional":true},{"name":"Kubernetes","optional":true},{"name":"OpenTelemetry","optional":true},{"name":"Sentry","optional":true},{"name":"SOC 2","optional":true}],"status":"live","first_seen_at":"2026-10-06T02:21:31Z","employer_posted_date":"2026-10-06","last_verified_at":"2026-10-21T01:13:38Z","board_verified":true,"closed_at":null,"days_open":15,"trust":{"level":"ok","repost_count":null,"flags":[],"days_open":15},"description":"At Commure, we're building the AI Operating System for healthcare, the foundation that defines how care is delivered, documented, and financed. Our platform spans the full care journey: Ambient AI and Dictation eliminating documentation burden at the point of care, intelligent Agents automating patient and revenue workflows, and autonomous RCM processing billions in claims, all on a single AI-native platform integrated with 60+ EHRs.\nHealthcare carries a $1 trillion administrative burden and we're at the center of transforming it. Today, 500,000+ clinicians across 500+ healthcare organizations nationwide trust Commure to handle $25B+ in annual claims and support over 200 million patient interactions. Our latest $70M raise at a $7B valuation reflects the confidence the market has placed in this mission. We've also been named to the Fortune Future 50 list and the 2026 AI Breakthrough Awards for “Overall NLP Company of the Year.”\nOur team works directly alongside clinicians, not through layers of process, which means the gap between what you build and its impact on patient care is immediate. We move fast, deploy daily, and take full ownership from early thinking to production. If you're energized by hard problems, high stakes, and a team that holds itself to a high bar, you'll find your people here.\nThe future of healthcare is being built right now. Come deliver this transformation.\nAbout the Role\nWe’re building a next-generation ambient AI product suite for healthcare, helping clinicians focus on patient care by automatically capturing, understanding, and structuring clinical conversations.\nBehind that experience is a distributed system responsible for ingesting long-form audio, processing real-time and asynchronous streams, orchestrating multiple AI models, and reliably producing clinical outputs. These workflows must remain observable and recoverable across network interruptions, partial failures, model timeouts, and rapidly changing inference infrastructure.\nWe’re hiring a Staff Backend Engineer to help build and operate this foundation. You’ll work across audio ingestion, media processing, inference orchestration, distributed workflows, storage, observability, and cloud infrastructure.\nThis role is ideal for an engineer who enjoys making complex systems dependable. You think carefully about failure modes, idempotency, backpressure, data integrity, latency, and operational simplicity. You also understand that infrastructure exists to serve the product: the systems you build must ultimately create a fast, reliable, and trustworthy experience for clinicians.\nWhat You’ll Do\nDesign, build, and operate backend systems that power our Ambient AI products across mobile and web.\n\nBuild and evolve inference workflows that coordinate transcription, diarization, language models, clinical extraction, summarization, and other AI capabilities.\n\nDevelop orchestration systems for long-running, multi-stage workflows, including:\nScheduling, queueing, and workload prioritization\n\nRetries, timeouts, fallbacks, and dead-letter handling\n\nIdempotency, replay, and safe workflow recovery\n\nModel routing, versioning, and configuration\n\nProgress tracking and user-visible workflow state\n\nGraceful degradation when dependencies are unavailable\n\nImprove the reliability and scalability of services operating under variable, compute-intensive workloads.\n\nDefine and maintain service-level objectives for critical workflows, including availability, processing latency, completion rates, and data durability.\n\nBuild strong observability across services and pipelines through structured logging, metrics, distributed tracing, dashboards, alerting, and diagnostic tooling.\n\nLead incident response and post-incident analysis for important production failures, turning operational lessons into lasting improvements.\n\nIdentify systemic failure patterns and eliminate them through better abstractions, automation, testing, and architecture.\n\nImprove cloud infrastructure, deployment systems, capacity planning, and operational tooling as the platform scales.\n\nDesign APIs and data models that allow mobile, web, and internal systems to interact with long-running workflows safely and predictably.\n\nBuild tools that make inference pipelines easier to inspect, test, replay, evaluate, and debug.\n\nBalance reliability, latency, quality, and infrastructure cost across AI and media-processing workloads.\n\nPartner closely with mobile, product, AI, security, and clinical teams to turn new capabilities into production-ready workflows.\n\nMentor other engineers and help establish strong practices for distributed systems, observability, operational readiness, and backend architecture.\n\nWhat You Have\n8+ years of professional backend or infrastructure engineering experience.\n\nExperience designing, building, and operating production distributed systems.\n\nStrong proficiency in at least one modern backend programming language.\n\nExperience with asynchronous processing, message queues, event-driven systems, or durable workflow execution.\n\nA strong understanding of distributed-systems concepts such as idempotency, consistency, concurrency, backpressure, retries, failure isolation, and eventual completion.\n\nExperience operating services in a cloud environment, including deployment, monitoring, scaling, and incident response.\n\nExperience designing APIs, service boundaries, and data models for complex product workflows.\n\nA track record of improving system reliability, observability, scalability, or operational efficiency.\n\nStrong debugging skills across application, infrastructure, data, and external dependency boundaries.\n\nAn ability to reason about both real-time and long-running workloads with different latency and durability requirements.\n\nComfort working across backend, infrastructure, product, and AI systems rather than within a narrowly defined layer.\n\nAn ownership mindset and bias for action. You identify important risks, create clarity, and drive ambiguous infrastructure work through completion.\n\nNice to Haves\nExperience building speech-to-text, diarization, transcription, or other audio-based machine-learning workflows.\n\nExperience orchestrating large language models or multi-model inference pipelines in production.\n\nFamiliarity with workflow orchestration systems such as Temporal or similar durable execution platforms.\n\nExperience with event-streaming and messaging technologies such as Kafka, Pub/Sub, SQS, or similar systems.\n\nExperience with model routing, inference gateways, rate limiting, batching, caching, or GPU-backed workloads.\n\nExperience building internal tooling for workflow inspection, replay, evaluation, or model debugging.\n\nExperience defining SLOs, managing error budgets, designing alerts, and leading production incident response.\n\nFamiliarity with distributed tracing and observability platforms such as Grafana, OpenTelemetry, Sentry, or similar tools.\n\nExperience with containers, Kubernetes, infrastructure as code, and cloud-native deployment systems.\n\nExperience optimizing systems for throughput, tail latency, infrastructure cost, and workload isolation.\n\nExperience with offline clients, background synchronization, or systems that reconcile delayed and duplicated events.\n\nExposure to healthcare, HIPAA, SOC 2, encryption, privacy, security, or other regulated environments.\n\nExperience supporting AI-native, real-time, or agentic product experiences.\n\nWhy Join\nBuild the backend foundation for an AI healthcare product used in real clinical workflows.\n\nSolve challenging systems problems involving distributed orchestration, and production AI.\n\nMake reliability improvements that clinicians experience directly through faster, safer, and more dependable workflows.\n\nShape how inference systems are orchestrated, observed, recovered, and scaled in production.\n\nWork closely with product and AI teams while maintaining deep ownership of backend architecture and infrastructure.\n\nHelp define the operational and engineering standards for a rapidly growing platform.\n\nJoin at a stage where core systems, technical strategy, and engineering culture are still highly shapeable.\n\nGrow into broader backend, infrastructure, or technical leadership as the team and product expand.\n\nPlease be aware that all official communication from us will come exclusively from email addresses ending in @commure.com. Any emails from other domains are not affiliated with our organization.\nEmployees will act in accordance with the organization’s information security policies, to include but not limited to protecting assets from unauthorized access, disclosure, modification, destruction or interference nor execute particular security processes or activities. Employees will report to the information security office any confirmed or potential events or other risks to the organization. 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