Lead Engineer (Backend)

About Onos Health

Onos Health's mission is ambitious - ensure every healthcare dollar is spent on delivering the highest quality care. With up to 50 cents of every healthcare dollar wasted, Onos' AI-powered platform is positioned to drive meaningful change in the industry.

Onos empowers health plans to ensure their members receive the highest quality care while reducing billions in wasteful and abusive spending. By identifying providers who deviate from an evidence-based care standard, we enable health plans to take action before their members' health outcomes are impacted.

As one of our early engineering hires reporting directly to the CTO, you'll have the opportunity to shape our technical foundation from the ground up. You'll help to build sophisticated AI/ML systems that directly impact mental healthcare delivery while working alongside a team with decades of behavioral health experience.

Why Onos?

Meaningful impact: Help improve the quality of care while reducing healthcare costs

Direct collaboration with experienced founders who have deep healthcare expertise

Collaborative, transparent & results-oriented culture

Significant ownership of technical decisions and architecture from day one

Opportunity to help build and lead an engineering team from the ground up The Role

We're seeking a passionate technical leader (Senior/Manager level) who is motivated to meaningfully improve the way healthcare is administered in the United States. You'll take ownership of developing a significant part of the Onos platform through hands-on development and technical leadership. As an early team member, you'll work closely with our founding team while helping to build and lead a growing engineering team. This role is a hybrid role based in San Francisco, where you'll be expected to work at our office in person at least once a week.

What you'll be doing at Onos:

Architecting and implementing major platform components to provide actionable insights and recommendations to health plan administrators

Build and scale data pipelines for health records, provider directories, and claims processing

Establish engineering best practices and technical foundations for future team growth

Shape our technical roadmap, make key architectural decisions, and influence the company's product strategy Technical Challenges At Onos:

Develop an intelligent engine that ingests complex medical standards of care documents and evaluates provider adherence to guidelines

Design and implement sophisticated anomaly detection systems to identify fraudulent or abusive providers

Build ML pipelines to analyze handwritten clinical notes and automate recommendations for clinical reviewers

Scale our systems to process millions of healthcare records while maintaining strict security and compliance requirements Tech Stack:

At Onos, we work with a modern tech stack where you'll have the freedom to evaluate and adopt cutting-edge technologies as we scale.

Languages/Frameworks: Python, Django, Typescript, NextJS

Database/Storage: PostgreSQL (AWS RDS), S3

Infrastructure/Systems: AWS (ECS, Bedrock, etc.), Docker

Development Tools: Github, Jira, Cursor What we're looking for:

5+ years experience building software applications

Customer obsessed and motivated to make an impact in the healthcare space

Expertise with data engineering and backend web development practices

A collaborative team player with an eye for the details Bonus points if you have:

Significant experience working with healthcare data and with HIPAA best practices

Worked with machine learning and large language models for end-user applications

Built and managed teams of engineers on major software projects Benefits and Perks

Flexible hybrid arrangement: 1-2 days/week at San Francisco office (financial district), remote-first culture

Unlimited vacation policy

Paid parental leave

Medical, dental, and vision insurance

Pre-tax commuter benefits

401(k)

Significant equity as an early employee

Direct mentorship from experienced founders

Ground-floor opportunity to help build a team and culture

Regular team events and offsites

Company-provided equipment and home office setup

We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.