Senior Software Engineer Backend (NYC)

Flagler Health is building the clinical operating system for modern musculoskeletal care. We partner with MSK provider groups and specialty clinics to help them grow, operate more efficiently, and deliver better longitudinal care across patient acquisition, clinical workflows, and ongoing patient engagement. Our platform sits at the intersection of care delivery and clinic operations, helping providers capture more value across the full patient lifecycle. We’ve recently raised our Series B and are entering our next phase of growth. Key Responsibilities Design, build, and maintain backend services and web applications Work on real-time web applications for audio and SMS communications with users (patients) Implement and operate fault-tolerant, long-running workflows for asynchronous and background processing Collaborate with frontend, product, and infrastructure teams to deliver reliable, compliant systems Required Qualifications Proven experience building highly available backend applications in a regulated environment (e.g., healthcare, finance, compliance-driven SaaS) Proficiency in TypeScript and/or Python for backend service development Experience interacting with backend APIs built using Node.js, Express, Mongoose, Twilio or similar frameworks Experience with Temporal or similar distributed workflow orchestration systems (e.g., Cadence, AWS Step Functions, Conductor) Solid understanding of distributed systems fundamentals, including retries, idempotency, and failure handling Preferred Qualifications Experience in healthcare technology or SaaS platforms at a medium-sized startup Familiarity with HL7, FHIR, or EHR integrations Experience with cloud platforms such as AWS, Azure, or GCP Hands-on experience with CI/CD pipelines , infrastructure automation, and version control systems (e.g., Git) Experience working in a monorepo setup (e.g., Turborepo, Nx) Nice to have: Experience with distributed data or batch processing frameworks (e.g., Apache Spark, Databricks, o