Software Engineer - Core Systems

Reposted One Month Ago
San Francisco, CA, USA
In-Office
Senior level
Healthtech • Software
The Role
Build and operate backend services, secure integrations with hospital systems (PACS/RIS/EHR) using DICOM/HL7/FHIR, design cloud networking and site connectivity, run production ETL/data pipelines and CI/CD, ensure HIPAA-compliant handling of PHI, and support ML inference and infrastructure across design-to-deployment lifecycles.
Summary Generated by Built In
About Us

Epsilon Health is transforming medical imaging and diagnostics by bringing frontier AI into clinical practice. We're tackling some of healthcare's most critical challenges, building technology that directly improves patient outcomes.

This year, we've served over 300,000 patients and now serve 3,000+ daily, working with some of the largest medical institutions in the U.S. By year-end, we're on track to interpret 1% of all daily U.S. X-rays.

Our research team brings experience from DeepMind and Meta, powered by one of the industry's most comprehensive proprietary medical imaging datasets, continuously enriched by real-world clinical data. Together, we're building a future where frontier AI helps save millions of lives today, not tomorrow.

Recently out of stealth, we're proudly backed by Jack Altman, Uncork Capital, Renegade Partners, and AlleyCorp, one of NYC's most active healthcare venture firms.

 
Role Overview

We're looking for Software Engineers to help us build and operate the core infrastructure that powers Epsilon Health, composed of 3 major components: an ingestion pipeline, a data warehouse / pipeline and a distributed inference system.

You'll work across the backend stack, designing services, evolving schemas, improving observability, and keeping production healthy. This isn't a role where you'll own a single microservice. We expect you to understand how the pieces fit together, make thoughtful architectural decisions, and leave the system simpler than you found it.

We don't have a separate SRE organization. Reliability, operations, debugging, and capacity planning are part of engineering here. As Epsilon Health grows, one of your most important jobs will be making sure the backend grows without becoming unnecessarily complicated.

You'll be working closely with the ML team, lending a hand on ML infrastructure when priorities demand, and you'll do well here if you like owning ambiguous, high-impact problems end to end.

Key Responsibilities
  • Design, build, and operate infrastructure that deliver reliable end-to-end experiences from data ingestion through model output.

  • Design and implement robust data pipelines and warehouses to collect, process, and store large-scale multimodal medical imaging data from both production traffic and offline sources.

  • Build CI/CD and deployment automation that lets a lean team ship quickly and safely.

  • Ensure systems handling PHI are HIPAA-compliant by design, with encryption, access controls, audit logging, and secure data handling throughout.

  • Build model inference pipelines for live and offline traffic, and support ML infrastructure alongside the ML team as needs arise.

  • Leading technical design, driving quality through design reviews and testing, and helping set engineering best practices on a lean team.

Qualifications
  • 6+ years of experience building data infrastructure, storage systems, or related distributed systems

  • Have 2+ years of experience leading large scale, complex projects or teams as an engineer or tech lead

  • Proficiency in a backend language (Go, Python, Java, or similar)

  • Experience designing, building, and operating large-scale distributed systems or infrastructure (we use AWS) in production

  • Strong problem-solving skills and the ability to troubleshoot complex distributed systems

  • Can navigate complex technical tradeoffs between performance, cost, security, and maintainability

  • Track record of leading complex, multi-quarter technical initiatives spanning multiple teams or systems

Preferred Qualifications
  • Experience operating in a startup or startup-like environment, i.e. a small, fast-moving team with high autonomy

  • Proficiency in modern web application technologies for the frontend (e.g., TypeScript, React) with a strong understanding of web architecture

  • Experience building and operating HIPAA-compliant systems, or handling PHI and healthcare security requirements

  • Experience with large-scale ETL, data lake, or data warehouse systems

  • Experience contributing to ML infrastructure or model inference pipelines

The anticipated annual base salary for this position is up to $250,000. This range does not include any other compensation components or other benefits for which an individual may be eligible. The actual base salary offered depends on a variety of factors, which may include as applicable, the qualifications of the individual applicant for the position, years of relevant experience, specific and unique skills, level of education attained, certifications or other professional licenses held, and the location in which the applicant lives and/or from which they will be performing the job.

Skills Required

  • 5+ years as a software engineer
  • Proficiency in a backend language (Go, Python, Java, or similar)
  • Strong experience with cloud platforms and distributed architectures, particularly AWS
  • Experience designing and building backend infrastructure (APIs, data pipelines, services)
  • Hands-on experience with schema design and data modeling
  • Experience building and integrating with external or third-party systems, including networking and security across organizational boundaries
  • Strong problem-solving and troubleshooting skills for complex distributed systems
  • Ability to ship quickly under competing priorities in a lean team
  • Excellent communication skills and ability to work cross-functionally and with external customers/vendors
  • Experience with healthcare integration standards and imaging systems (DICOM, DICOMweb, HL7, FHIR, PACS/RIS, IHE profiles)
  • Experience building and operating HIPAA-compliant systems or handling PHI and healthcare security requirements
  • Experience with secure network integration (site-to-site VPNs, private connectivity) and onboarding enterprise/hospital customers
  • Experience with CI/CD tooling and infrastructure-as-code (Terraform, Docker, Kubernetes)
  • Experience with large-scale ETL, data lake, or data warehouse systems
  • Experience contributing to ML infrastructure or model inference pipelines
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The Company
6 Employees
Year Founded: 2024

What We Do

Epsilon Health exists to solve the looming global radiology crisis before it reshapes patient care. Radiology underpins nearly every medical specialty, yet it is one of the most strained parts of the healthcare system. We’re rethinking how imaging and interpretation work to make radiology faster, more reliable, and future-proof.

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