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Ellipsis Health

Senior Backend Engineer, Infrastructure

San Francisco, California, United States

Location
San Francisco, California, United States
Work
Hybrid
Employment
Full-time
Level
Senior
Function
Engineering
Pay
$160K – $250K a year
Posted
6 months ago

Pay and the market here

The top of this role’s range, $250K a year, is 4% above the median of $240K for senior engineering jobs in San Francisco (middle half $210K – $270K, 1,147 jobs that state pay).

5,003 engineering jobs open in San Francisco: 9% remote, 949 posted in the last 30 days.

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About the role

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.

In this role, you will be a core contributor and technical leader within our AI Research & Engineering team. Operating at the sweet spot between cutting-edge scientific research and production-grade systems, you will drive the conceptualization, architecture, and deployment of frontier agentic systems. You will collaborate directly with core infrastructure and platform teams to translate algorithmic breakthroughs in LLMs and agentic AI into robust, secure, and low-latency clinical applications.

Responsibilities

  • Expand and maintain our real-time voice pipeline: design, implement, and maintain Python micro-services for conversational AI orchestration—audio capture, streaming transcription, prompt/LLM logic, synthesis, and playback.
  • Integrate new providers & transports: add plug-ins for emerging ASR, TTS, LLM, and memory services; wire up WebRTC, SIP, or phone endpoints; build adapters that allow hot-swapping components without downtime. Build API endpoints.
  • Deliver ultra-low latency (<500 ms round-trip): profile async pipelines (asyncio, FastAPI, gRPC), optimize buffering, concurrency, and back-pressure handling.
  • Instrument & observe every hop: emit structured traces (OpenTelemetry), metrics, and logs for each pipeline stage; define SLOs for first-token latency, end-to-end latency, and streaming reliability.
  • Harden for production: implement graceful retries, idempotent message passing, circuit breakers, and HIPAA-compliant security (encryption in transit, per-tenant isolation, secrets rotation).
  • Collaborate cross-functionally with ML, product, data engineering, and client-SDK teams to deliver features such as voice cloning, multimodal hand-offs, and domain-specific memory retrieval.

Qualifications

  • 4+ years building production back-ends in modern Python.
  • Proven experience with real-time streaming systems—WebRTC, WebSockets, or gRPC streaming—and proficiency with asyncio, FastAPI, or similar async frameworks.
  • Deep understanding of concurrency, buffering, audio codecs (Opus, PCM), and distributed tracing.
  • Solid understanding of AWS/GCP/Azure, including container orchestration (Kubernetes/EKS/GKE), message queues (Kafka/SQS/Pub/Sub), and IaC (Terraform).
  • Solid grasp of relational (PostgreSQL) and in-memory (Redis) data stores; able to model and persist conversational state.
  • Excellent communication skills and a bias for measured, observable, and continuously deployable software. Bonus Points:
  • B.S./M.S. in CS, EE, or related fields.
  • Familiarity with voice-agent frameworks,
  • Hands-on with telephony (Twilio, Telnyx), SIP, or PSTN integrations.
  • Experience integrating multimodal inputs (vision, text chat) into voice agents.
  • Familiarity with GPU inference and streaming pipelines.
  • Prior work in regulated industries (healthcare, finance) and comfort preparing for
  • SOC 2 / HIPAA audits.

Salary and Benefits

We offer competitive salary and benefits, including 401k matching up to a certain

percentage of your salary, health, vision, and dental insurance, and very flexible paid

time off.

The typical salary range for this role is $175,000 to $250,000 USD. The amount

offered will be determined by a variety of factors including but not necessarily limited to

your individual skills, qualifications, and past experience relative to the requirements of

the role.

Background Checks

As a health technology company, we reserve the right to run a background check on

any applicant to which we extend an offer and to re-perform any such check at any time

during the course of employment. Please know that there is no set policy on rejecting

candidates because of certain background check results, and that we look at a

candidate as a whole before making any decisions. We comply with all “ban the box”

laws in applicable jurisdictions.

Assistance

If you have a disability or otherwise require any assistance whatsoever in the

application or recruitment process, please feel free to submit a request to

careers@ellipsishealth.com.

Source

Posted by Ellipsis Health on their own hiring page, jobs.ashbyhq.com. OptiTalent shows it as published, read 07 Nov 2026 11:47 UTC; the original is the reference.

View the original ad ↗

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