Senior Backend Engineer 💻 (Event-Driven Architecture, AI-Enabled Systems) at Legion Health (S21)
$120K - $180K  •  0.10% - 0.60%
AI-native psychiatry, built for scale and covered by insurance
San Francisco, CA, US
Full-time
6+ years
About Legion Health

We’re rebuilding psychiatry from the ground up—AI-native, insurance-covered, and engineered to scale.

Legion Health is a high-quality psychiatry network where patients get care from licensed clinicians, fast and affordably. Under the hood, our LLM agents and orchestration layer automate operations, reduce admin, and enable truly great care.

Most startups bolt AI onto broken workflows. We’re replacing the workflows—and the system underneath.

If you’ve ever wanted to use AI to actually fix something that matters, this is your shot.

About the role
Skills: Redis, Express, Node.js, RabbitMQ, TypeScript, Kafka, ETL, PostgreSQL

🚀 Legion Health | AI-Driven Psychiatric Care – We’re Hiring!

**Join us in building the most efficient, AI-powered mental healthcare system.**
We’re a YC-backed company revolutionizing telepsychiatry—not with AI for diagnostics, but with AI-driven operations that actually make patient care faster, smoother, and more accessible.

We’re hiring top-tier engineers who thrive in high-velocity, AI-first environments and want to build technology that meaningfully improves lives. If you love shipping fast, working with AI, and solving hard problems, keep reading. 👇

Why This Role?

  • You’ll own the architecture for a next-gen, AI-driven healthcare system.
  • You’ll design event-driven systems that integrate LLM-powered automation across scheduling, billing, and patient interactions.
  • You’ll scale a backend that supports thousands of patients while maintaining HIPAA compliance & security.
  • You’ll shape the future of AI in healthcare, working directly with the founding team.

What You’ll Work On

  • Architecting and implementing a highly-scalable, event-driven backend using Node.js, Supabase (Postgres), and AWS.
  • Building real-time, AI-powered patient and provider workflows that optimize scheduling, intake, and operational efficiency.
  • Designing robust event pipelines to capture and structure rich operational data (call transcripts, scheduling metadata, etc.).
  • Ensuring high availability, reliability, and security—handling PHI data while keeping everything fast and seamless.
  • Collaborating with our AI and front-end teams to build an integrated, LLM-powered care delivery system.

What We’re Looking For

  • 5+ years of experience in backend engineering (Node.js, TypeScript, Postgres).
  • Expertise in event-driven systems, message queues, or stateful data architectures.
  • Experience with real-time data processing (e.g., webhooks, Kafka, or event sourcing).
  • Comfortable working with LLMs—you don’t need deep AI expertise, but you should be excited to build AI-first systems.
  • Strong security and compliance mindset (HIPAA or other regulated environments is a huge plus).

What We Offer

  • $70-200K salary + 0.2-1.0% equity (commensurate with experience).
  • A high-velocity team—you will ship and own your work.
  • A mission that matters—we’re solving real healthcare problems at scale.
  • Deep AI integration—you’ll be at the frontier of operational AI in healthcare.

🚀 Apply now

Technology

Technology at Legion

We are revolutionizing telepsychiatry through a core AI infrastructure that enables a vastly improved patient experience and quality of mental health care. We are actively improving our services in ingesting, chunking, embedding, caching, and searching to achieve this goal. Our technical goals include:

  • Enhanced processing: Implement robust data structures and caching mechanisms to handle increasing volumes of language data spanning every facet of patients’ care while minimizing latency and maximizing system responsiveness.
  • System scalability: Ensure our systems can scale effectively to support growth from one million to hundreds of millions of data points.
  • Securing sensitive data: Uphold the highest standards of data security and privacy in compliance with HIPAA guidelines.

##Stack TypeScript, Node.js, PostgreSQL, Redis, Supabase, Azure, Google Cloud, AWS, LangChain, PostHog, Retool

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