Infrastructure Engineer (Backend)

Counsel’s mission is to multiply the world's healthcare capacity. We believe in a future in which every person has a personalized, AI-enabled doctor always in their pocket. To accomplish this, we’re building the first fully-vertical, AI-native medical group from the ground up. We’ve redesigned the entire clinical stack with custom AI tools that make our in-house physicians 10x faster and smarter. [learn more on our blog]
Since our founding in 2023, we have formed partnerships with leading healthcare organizations and are on track to serve hundreds of thousands of patients on our platform within the next year. We have raised over $35M from a16z, Google Ventures, Pear VC and other top-tier VC firms.
Our team combines deep expertise in medicine (Harvard, Mt. Sinai, Mass General, UCSF) and technology (Google, DeepMind, NVIDIA, MIT, Stripe) — and we’re looking for exceptional people to join us as we scale.
Join us as we build the future of AI in healthcare!

At Counsel Health, we've built a product that patients and physicians love on a fast-moving stack. As we scale, the surface area between "application code" and "infrastructure" is growing — and we need someone who lives at that intersection.

We are looking for a Backend Infrastructure Engineer who is equal parts software engineer and infrastructure engineer. You won't be sitting in a silo writing Terraform all day, and you won't be shipping product features in React. You'll operate on the critical layer in between: the CI/CD pipelines, the IaC that provisions our AWS environment, the backend services that glue our systems together, and the developer tooling that keeps a fast-growing engineering team productive.

• Contribute to Our Infrastructure-as-Code: develop and maintain our cloud infrastructure using Terraform.

• Build & Improve CI/CD: Own our build, test, and deployment pipelines end-to-end. Your goal is to make deploying to production boring — fast, reliable, and automatic.

• Backend Engineering: Write production backend services and contribute to core server-side systems. You're comfortable writing application code, not just orchestrating it.

• Build Core Archetypes: Write production grade archetypes for new deployments, jobs, consumers, and workers. You’re comfortable building out an abstract base stream consumer or cron executor for widespread use.

• Developer Experience: Be the engineer who makes other engineers faster. Improve local dev workflows, reduce build times, eliminate flaky infrastructure, and build internal tooling that the team actually wants to use.

• Security & Compliance: Work closely with our security and compliance team to harden our infrastructure posture — secrets management, IAM policies, network isolation, and audit logging in a HIPAA-regulated environment.

• A Bridge Builder: You're equally comfortable in an IDE writing application code and in a terminal managing cloud infrastructure. You don't see "backend" and "infra" as separate disciplines.

• An Automation Leader: If you do something manually twice, you're already writing the script to automate it the third time.

• Systems Thinker: You understand how a request flows from a user's browser through a load balancer, into a container, hits a database, and comes back — and you can debug any layer of that stack.

• Pragmatic & Shipping-Oriented: You pick the right tool for the job, not the trendy one. You'd rather ship a working solution today than architect a perfect one next quarter.

• A Strong Communicator: You can explain infrastructure decisions to product engineers and translate product requirements into infrastructure changes.

• 3-5 years of professional experience in backend engineering, infrastructure engineering, or a hybrid of both.

• Strong proficiency in at least one strongly-typed or compiled language (Go, Rust, Java, Typed Python, TypeScript, etc.).

• Experience with AWS/GCP/Azure cloud services.

• Familiarity with containerized environments and Docker.

• Hands-on experience writing and maintaining Terraform (or equivalent IaC tooling).

• Proven track record building and maintaining CI/CD pipelines (GitHub Actions, CircleCI, or similar).

• Kubernetes experience

• Experience with TypeScript/Node.js.

• Experience working in a regulated environment (HIPAA, SOC 2, etc.) -- strong plus!

Our backend platform is built to support large-scale AI-driven clinical systems and enterprise integrations.

• Languages: TypeScript, Node.js

• Infrastructure: SQS, Temporal, AWS, GCP, Docker, Kubernetes

• Data: PostgreSQL, Redis, time-series and vector storage with GCP

We value strong engineering fundamentals over familiarity with any specific tool. If you’ve built robust distributed systems and high-quality APIs before, you’ll ramp quickly in our stack.

Location for this role:

NYC - hybrid, Boston - hybrid, East Coast - remote

• Impact: Be at the forefront and contribute to groundbreaking, AI-driven healthcare experiences, directly interface with execs at the world's leading tech & healthcare orgs

• Growth: Significant opportunities for broad ownership and professional development within our rapidly scaling startup

• Compensation: Competitive salary + equity

• Benefits: Comprehensive healthcare, vision + dental, 401K, Unlimited PTO, Parental Leave

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• Patients come first.
  We are clinicians 1st, technologists 2nd. We act with patient trust/safety at the center of every decision.

• Innovate with optimism.
  We are optimistic as we build the future of care delivery from first principles. Challenge the status quo when needed, no sacred cows.

• Right answer wins.
  Debate openly and pick the strongest path. We optimize for the company, not functions. We win and lose as a team.

• Simplicity over complexity.
  We choose clear, elegant solutions and avoid adding complexity that does not serve patients or the team.

• Do fewer things, well.
  We focus, and hold ourselves to the highest bar and pursue excellence in those areas.

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Recruitment Fraud Notice
Counsel Health only communicates with candidates using official @counselhealth.com email addresses. We will never ask for payment or financial information during the interview process. If you receive suspicious outreach claiming to be from Counsel Health, please contact us at [email protected].

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