[Remote] Senior Backend Engineer (Python)

Note: The job is a remote job and is open to candidates in USA. Ellipsis Health is developing cutting-edge AI/ML products to address healthcare staffing issues and administrative burdens. The role involves expanding and maintaining real-time voice pipelines and collaborating cross-functionally to deliver innovative features for conversational AI.ResponsibilitiesExpand 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 playbackIntegrate 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 endpointsDeliver ultra-low latency (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 reliabilityHarden 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 retrievalSkills4+ years building production back-ends in modern PythonProven experience with real-time streaming systems—WebRTC, WebSockets, or gRPC streaming—and proficiency with asyncio, FastAPI, or similar async frameworksDeep understanding of concurrency, buffering, audio codecs (Opus, PCM), and distributed tracingSolid 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 stateExcellent communication skills and a bias for measured, observable, and continuously deployable softwareB.S./M.S. in CS, EE, or related fieldsFamiliarity with voice-agent frameworksHands-on with telephony (Twilio, Telnyx), SIP, or PSTN integrationsExperience integrating multimodal inputs (vision, text chat) into voice agentsFamiliarity with GPU inference and streaming pipelinesPrior work in regulated industries (healthcare, finance) and comfort preparing for SOC 2 / HIPAA auditsBenefits401k matching up to a certain percentage of your salaryHealth, vision, and dental insuranceVery flexible paid time offCompany OverviewAI Nursing Care Manager It was founded in 2017, and is headquartered in San Francisco, California, USA, with a workforce of 11-50 employees. Its website is http://www.ellipsishealth.com.Company H1B SponsorshipEllipsis Health has a track record of offering H1B sponsorships, with 2 in 2026, 6 in 2025, 1 in 2024, 2 in 2023, 1 in 2021. Please note that this does not guarantee sponsorship for this specific role.