{"id":449257,"url":"https://alion.io/job/ellipsis-health-senior-backend-engineer-infrastructure","title":"Senior Backend Engineer, Infrastructure","company":{"id":173507,"name":"Ellipsis Health","domain":"ellipsishealth.com","url":"https://alion.io/company/ellipsis-health","size_band":"201-500","is_staffing_agency":false,"employer_type":"direct","is_intermediary":false,"listed_via":null,"ats_vendor":"Ashby","truth_index":{"grade":"A","score":95,"open_postings":11,"ghost_share":0,"stale_share":0,"repost_share":0,"time_to_fill_p50_days":140,"computed_at":"2026-11-05T05:54:30Z"}},"role":"Backend","role_family":"Backend","seniority":"senior","employment_type":"full_time","work_mode":"hybrid","remote_scope":null,"remote_scope_basis":null,"remote_working_hours":null,"hiring_geo_confidence":"structured","locations":["San Francisco, United States"],"countries":["US"],"hiring_countries":[],"hiring_countries_total":0,"salary":{"min":175000,"max":250000,"currency":"USD","period":"year","gross":null,"usd_annual":250000},"salary_estimate":null,"experience_years_min":4,"visa_sponsorship":false,"relocation_package":false,"has_equity":false,"technologies":[{"name":"Amazon EKS","optional":false},{"name":"Apache Kafka","optional":false},{"name":"Asyncio","optional":false},{"name":"AWS","optional":false},{"name":"Azure","optional":false},{"name":"FastAPI","optional":false},{"name":"GCP","optional":false},{"name":"Google GKE","optional":false},{"name":"gRPC","optional":false},{"name":"HIPAA","optional":false},{"name":"Kubernetes","optional":false},{"name":"LLM","optional":false},{"name":"Multimodal AI","optional":false},{"name":"OpenTelemetry","optional":false},{"name":"PostgreSQL","optional":false},{"name":"Python","optional":false},{"name":"Redis","optional":false},{"name":"SLI/SLO/SLA","optional":false},{"name":"Speech Recognition","optional":false},{"name":"Terraform","optional":false},{"name":"Text-to-Speech","optional":false},{"name":"WebRTC","optional":false},{"name":"WebSockets","optional":false},{"name":"SOC 2","optional":true},{"name":"Twilio","optional":true},{"name":"Voice Agents","optional":true}],"status":"live","first_seen_at":"2026-05-01T22:01:57Z","employer_posted_date":"2026-05-01","last_verified_at":"2026-11-05T14:15:09Z","board_verified":true,"closed_at":null,"days_open":187,"trust":{"level":"ok","repost_count":0,"flags":["company_stale"],"days_open":187},"description":"Ellipsis Health is developing cutting-edge AI/ML products to address healthcare staffing issues and administrative burdens. The platform employs conversational AI and patented vocal biomarker technology to deliver improved healthcare experiences for clients and patients. The team is headquartered in Silicon Valley and is funded and supported by preeminent venture capital groups and healthcare institutions.\nResponsibilities:\nExpand and maintain our real-time voice pipeline: design, implement, and\nmaintain Python micro-services for conversational AI orchestration-audio\ncapture, streaming transcription, prompt/LLM logic, synthesis, and playback.\n\nIntegrate new providers & transports: add plug-ins for emerging ASR, TTS,\nLLM, and memory services; wire up WebRTC, SIP, or phone endpoints; build\nadapters that allow hot-swapping components without downtime. Build API\nendpoints.\n\nDeliver ultra-low latency (\nFastAPI, gRPC), optimize buffering, concurrency, and back-pressure handling.\n\nInstrument & observe every hop: emit structured traces (OpenTelemetry),\nmetrics, and logs for each pipeline stage; define SLOs for first-token latency,\nend-to-end latency, and streaming reliability.\n\nHarden for production: implement graceful retries, idempotent message\npassing, circuit breakers, and HIPAA-compliant security (encryption in transit,\nper-tenant isolation, secrets rotation).\n\nCollaborate cross-functionally with ML, product, data engineering, and\nclient-SDK teams to deliver features such as voice cloning, multimodal hand-offs,\nand domain-specific memory retrieval.\n\nQualifications:\n4+ years building production back-ends in modern Python.\n\nProven experience with real-time streaming systems-WebRTC, WebSockets,\nor gRPC streaming-and proficiency with asyncio, FastAPI, or similar async\nframeworks.\n\nDeep understanding of concurrency, buffering, audio codecs (Opus, PCM), and\ndistributed tracing.\n\nSolid understanding of AWS/GCP/Azure, including container orchestration\n(Kubernetes/EKS/GKE), message queues (Kafka/SQS/Pub/Sub), and IaC\n(Terraform).\n\nSolid grasp of relational (PostgreSQL) and in-memory (Redis) data stores; able\nto model and persist conversational state.\n\nExcellent communication skills and a bias for measured, observable, and\ncontinuously deployable software.\nBonus Points:\n\nB.S./M.S. in CS, EE, or related fields.\n\nFamiliarity with voice-agent frameworks,\n\nHands-on with telephony (Twilio, Telnyx), SIP, or PSTN integrations.\n\nExperience integrating multimodal inputs (vision, text chat) into voice agents.\n\nFamiliarity with GPU inference and streaming pipelines.\n\nPrior work in regulated industries (healthcare, finance) and comfort preparing for\n\nSOC 2 / HIPAA audits.\n\nSalary and Benefits\nWe offer competitive salary and benefits, including 401k matching up to a certain\npercentage of your salary, health, vision, and dental insurance, and very flexible paid\ntime off.\nThe typical salary range for this role is $175,000 to $250,000 USD. The amount\noffered will be determined by a variety of factors including but not necessarily limited to\nyour individual skills, qualifications, and past experience relative to the requirements of\nthe role.\nBackground Checks\nAs a health technology company, we reserve the right to run a background check on\nany applicant to which we extend an offer and to re-perform any such check at any time\nduring the course of employment. Please know that there is no set policy on rejecting\ncandidates because of certain background check results, and that we look at a\ncandidate as a whole before making any decisions. We comply with all “ban the box”\nlaws in applicable jurisdictions.\nAssistance\nIf you have a disability or otherwise require any assistance whatsoever in the\napplication or recruitment process, please feel free to submit a request to\n.","description_format":"text","description_chars":3831,"description_truncated":false,"requirements":{"experience_years_min":4,"management_years_min":null,"team_size_min":null,"manages_managers":false,"education":null,"security_clearance":false,"languages":[]},"benefits":["401k plan","Dental insurance"],"hiring_locations":[{"name":"United States","iso":"US","kind":"country"}],"hiring_excludes":[],"relocation_offered":false,"industries":["Medical AI","Digital Mental Health","Care Coordination & Population Health"],"lifecycle":[{"event":"open","at":"2026-09-06T08:14:02Z"}],"visa":[{"country":"US","licensed_sponsor":true,"evidence":"H-1B filings in 12 months: 16","filings_12m":16,"filings_prev_12m":2,"green_card_filings_12m":0,"median_offered_wage_usd":162500,"route":null,"cap_exempt":false,"checked_at":"2026-10-29T16:27:21+00:00","sources":["US Department of Labor: LCA disclosure data (H-1B, H-1B1, E-3)"],"filings_for_role_12m":11}],"liveness":{"score":34,"band":"fade","label":"Fading","p_open":1,"p_active":0.767,"p_room":0.44,"age_days":187,"expected_fill_days":140,"reasons":["conf:2","win:tail","crowd:"],"computed_at":"2026-11-05T05:54:30Z"},"pay":{"stated_usd_annual":250000,"is_top_pay":true},"html_url":"https://alion.io/job/ellipsis-health-senior-backend-engineer-infrastructure","json_url":"https://alion.io/job/ellipsis-health-senior-backend-engineer-infrastructure.json","meta":{"generated_at":"2026-11-05T18:59:11Z","cache_seconds":300,"methodology":"https://alion.io/methodology","terms":"https://alion.io/terms","contact":"https://alion.io/contact","api":"https://alion.io/developers","about":"Alion is a live layer of people, companies and AI agents: who they are, whether they are real and active right now, what they do and how to work with them, readable by people and by agents and paid per call.","catalog":"https://alion.io/catalog.json","usage":{"tier":"crawler_verified","counted_by":"address","units_charged":1,"used_today":25355,"day_limit":null,"remaining_today":null,"minute_limit":300,"resets_at":"2026-11-06T00:00:00Z"}},"offers":[{"id":"company.slices","title":"One company in depth, by slice","status":"live","price":{"credits":0.02,"usd":0.002,"plus_per_slice":{"credits":0.05,"usd":0.005}},"unit":"per company, plus each slice with data","note":"the employer in depth","call":{"mcp_tool":"get_company","arguments":{"id":173507},"rest":"https://alion.io/mcp/rest/get_company?id=173507"},"human":"https://alion.io/catalog?offer=company.slices&for=job%2Fellipsis-health-senior-backend-engineer-infrastructure"},{"id":"market.stats","title":"A market slice: pay, demand and time to fill","status":"live","price":{"credits":1,"usd":0.1},"unit":"per slice","note":"pay, demand and time to fill for this role and place","call":{"mcp_tool":"market_stats"},"human":"https://alion.io/catalog?offer=market.stats&for=job%2Fellipsis-health-senior-backend-engineer-infrastructure"},{"id":"job.search","title":"Open jobs by role, technology, place, pay and visa","status":"live","price":{"credits":0.02,"usd":0.002},"unit":"per posting in a list","note":"similar open postings","call":{"mcp_tool":"search_jobs"},"human":"https://alion.io/catalog?offer=job.search&for=job%2Fellipsis-health-senior-backend-engineer-infrastructure"},{"id":"company.verify","title":"Is this company real and active right now","status":"pilot","price":null,"unit":"per company","request":{"url":"https://alion.io/catalog/request","method":"POST","body":"{\"offer\": \"company.verify\", \"for\": \"job/ellipsis-health-senior-backend-engineer-infrastructure\", \"note\": \"what you need it for\"}"},"human":"https://alion.io/catalog?offer=company.verify&for=job%2Fellipsis-health-senior-backend-engineer-infrastructure"}],"agent":{"mcp":"https://alion.io/mcp/jobs","mcp_open":"https://alion.io/mcp/open","next":[{"tool":"get_job","arguments":{"id":449257}},{"tool":"search_jobs","arguments":{"company":"ellipsishealth.com","detail":"compact"}},{"tool":"match_people","arguments":{"job_id":449257},"note":"people open to offers who fit this vacancy"}],"note":"The same data through MCP tools: https://alion.io/mcp/open needs no sign-in (compact searches, postings, people); https://alion.io/mcp with an Alion account has everything. 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