Senior Full Stack Engineer-II

About Steer HealthSteer Health is an AI-native healthcare engagement platform serving 360+ healthcare organizations and 19 million patients. Our products - Luna AI (voice and patient engagement), SteerNotes (clinical documentation), and Digital Front Door - are replacing outdated patient workflows with autonomous, intelligent systems built for real clinical environments. We're not adding AI to healthcare software. We're rebuilding the digital workforce from the ground up. This is a high-growth moment - and we're building the engineering team that will get us thereAbout the Role:This is a senior individual contributor role with a direct track to technical leadership. You'll own systems end-to-end - not tickets - across voice AI, healthcare interoperability, event-driven automation, and clinical AI. The engineer who joins today has a clear line to Staff or Technical Lead as we scaleWhat You'll Build● Voice AI pipelines: multi-turn LLM agents, real-time STT/TTS (ElevenLabs, Deepgram),autonomous outbound calling, and intent resolution at scale● Event-driven orchestration: Kafka-powered A2A workflows and multi-step clinical automation across hundreds of healthcare organizations● Healthcare integrations: FHIR R4, HL7 v2.x, and production EHR connections with Epic,athenahealth, and eClinicalWorks● Clinical AI features: SteerNotes AI scribe, scheduling automation, and revenue cycleRequirements● 5+ years of backend or full-stack engineering with deep ownership of production systems● Meaningful experience building in or for healthcare: EHR integrations, FHIR/HL7, clinical workflows, or regulated data environments● Hands-on experience with LLMs, voice AI, or agent-based systems - you've shipped something that reasons, not just retrieves● Strong distributed systems intuition: event-driven architecture, async processing, real-time data at scale● A communicator and decision-maker - you can write a design doc, defend a trade-off, and mentor a junior engineer in the same week● Comfort in ambiguity and fast iteration; you don't need a perfect spec to start moving● A genuine belief that technology can meaningfully improve patient outcomesOur StackGCP / GKE · Kafka · FHIR R4 · HL7 v2.x · Node.js / TypeScript · Python · React · OpenAI / Claude APIs · ElevenLabs · Deepgram · Epic · athenahealth · eClinicalWorks · PostgreSQL · Redis · TwilioYour Growth Path● Days 1–90: Own a critical system end-to-end; ship your first production feature● Months 3–9: Lead cross-team initiatives; author architecture decisions; mentor junior engineers● Months 9–18: Shape engineering practices; own a product vertical; contribute to hiring● 18 months+: Technical Lead / Staff Engineer — setting direction for entire product linesWhy SteerThe work is genuinely hard. Healthcare interoperability is complex. Voice AI at clinical quality is largely unsolved. Multi-step automation with real patient outcomes requires precision most software never demands.Benefits Competitive base salary + equity in a high-growth company● Direct access to founders and executive leadership● Full healthcare, dental, and vision coverage● Flexible remote culture with in-person offsites● Learning and conference budget● Work on problems that directly impact real patients

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