Senior Backend Engineer, Workflow Systems

About the role

Kinstead is building the AI-native operating system for independent healthcare, enabling nurse practitioners to launch and run their own clinics. We replace the fragmented, manual infrastructure behind healthcare with a single, intelligent system so clinicians can spend their time on care, not paperwork. This creates a new model of care, one where clinicians practice on their terms and patients get consistent, community-rooted care.

How We Work

• We use tools such as Claude Code, GitHub Copilot, and Codex heavily throughout development.
• Engineers are responsible for what ships. We expect people to understand system behavior, review generated code carefully, debug failures, and maintain a high bar for reliability, security, and production quality.
• We look for engineers who use AI for leverage while still owning their code end-to-end. We review meaningful changes together as a team so everyone maintains context on how the system works end-to-end.

What You’ll Do

• Design and implement backend workflows and application logic
• Build and maintain APIs that power product functionality
• Implement scheduling, encounter, and operational workflows
• Build AI-powered tools that help clinicians with documentation, clinical decision support, and voice-driven workflows
• Integrate with clinical systems using FHIR
• Debug and resolve production issues across the stack
• Ensure system behavior remains predictable under failure conditions
• Collaborate with frontend engineers to maintain clear API contracts
• Use AI development tools to accelerate implementation while maintaining reliability
• Participate in system design and technical planning

Our Stack

• Python (Django, async-first with django-ninja and Channels)
• Next.js
• PostgreSQL (with pgvector)
• Redis
• WebSockets
• asynchronous background jobs
• workflow state machines
• clinical integrations using Medplum and FHIR

Requirements

• 5+ years building production software systems
• Strong Python experience. Familiarity with asynchronous programming in any language
• Experience designing and maintaining APIs for production applications
• Experience building backend systems beyond request/response — background jobs, event-driven patterns, or async processing
• Strong debugging and problem-solving skills
• Ability to design systems that behave predictably when things go wrong
• Comfort working in an AI-assisted development workflow

Nice to Have

• Experience with React or NextJS
• Experience building workflow or state-machine-driven systems
• Experience reasoning about stateful systems
• Experience with FHIR or healthcare data systems (helpful but not required)
• Experience with Kubernetes or distributed systems
• Experience working in early-stage startups