Founding Engineer, Forward Deployed

Care should be paid for the moment it’s delivered. At Backbone, we’re making that possible for the first time by building the clinical AI layer for healthcare payments.

Today, U.S. healthcare wastes more than $350B yearly on administrative work that has nothing to do with patient care: prior authorizations, denials, appeals, and the staff hired on both sides of the aisle to adjudicate and determine payment for services rendered. As a result, patient care is delayed, clinicians burn out, margins crater, and hundreds of billions of dollars that should be funding care end up funding the friction itself.

Backbone is dismantling this friction, building intelligent financial rails atop clinical AI research to facilitate instant payments between payers and providers. We're backed by Andreessen Horowitz (a16z), Lightspeed, Hanabi, and a roster of operators and clinicians who have built and run the largest payers, providers, and healthcare technology platforms in the country. Our founder/CEO, Manan Shah, holds a BS/MS in Math & CS from Stanford and led ML infrastructure at Sequoia-backed Kumo AI, where he built graph neural networks serving DoorDash, Reddit, and Coinbase.

Backbone’s revenue is growing quickly, customer demand is outpacing our team, and the road ahead is bright.

As one of the core members of our engineering team, you’ll sit close to providers and payers, understand how their workflows actually run, and turn what you learn into product implementation. You’ll close the loop from customer pain to shipped software: observe the workflow, understand the clinical and operational context, identify what needs to change, build it, deploy it, and make sure it works.

You’ll spend meaningful time with customers, but the center of gravity is engineering. We’re looking for someone who can communicate clearly, think like a product owner, and ship like a strong engineer.

You will:

Sit with providers, payers, and operations teams to understand how authorizations, claims, denials, appeals, and payment workflows actually happen.