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About the Role

We are hiring a second Staff Engineer to own key parts of our backend and data platform. Our platform supports teams identifying eligible patients for clinical trials and navigating patient enrollment barriers. This role involves technical leadership of critical systems during a massive architectural shift from human-assisted data pulls to robust, automated EMR integrations for complete patient records. The ideal candidate is excited by cloud-native architecture, building AI agents, exploring non-deterministic patient-trial matching, and handling HIPAA-grade data. Our engineering culture values direct communication, strong ownership, low-ego collaboration, quick decisions, open feedback, and a strong bias toward action.

Responsibilities

Own systems powering Trial Library's core workflows, ensuring their reliability, evolution, and scale.
Design for reliability in compute-intensive, long-running workflows, addressing issues like serial processing under load and production incidents due to timeouts.
Independently monitor production, triage issues quickly, and maintain a close understanding of the platform's experience for clinicians, coordinators, and partners.
Exercise pragmatic judgment, matching technology to business needs, including decisions on AI models and operationalizing 'token economics'.
Shape engineering practices at Trial Library, continuously rethinking engineering excellence as AI coding tools and models evolve.
Transition the team into a world less bottlenecked by execution, and more by review and verification.
Keep a close pulse on how AI is changing software development, critically evaluate emerging practices, and champion suitable approaches for the organization.
Mentor engineers and set development standards that remain relevant with evolving tools.

Requirements

Significant backend depth.
8 or more years of experience.
At least a couple of years operating at staff scope or equivalent impact.
Demonstrated high-impact ownership.
Deep AWS experience (Lambda, Fargate, SQS, RDS, and the surrounding ecosystem).
Ability to choose the right AWS service for the right job.
Proven track record of leveraging AI coding tools creatively and effectively to build production systems.
Demonstrated ability to take autonomous ownership, identifying and resolving systemic issues independently.
Startup experience, building from scratch at an early-stage company.
Ability to treat ambiguity as an opportunity rather than an obstacle.
Strong systems thinking, encompassing backend architecture, APIs, databases, and scalability under real-world constraints.
Clear communication and influence, with the ability to explain tradeoffs to both engineers and non-engineers to earn trust through honesty.
Healthcare alignment with a genuine interest in improving clinical trial access and health equity.
HIPAA experience (strong plus).
Experience with data and analytics platforms, such as data warehouses, ETL pipelines, or external-facing reporting infrastructure (nice to have).
Familiarity with IaC tooling (Terraform, Pulumi, etc) (additive).
Familiarity with clinical or healthcare data standards (EHR/EMR, HL7/FHIR) (additive).
Familiarity with API design patterns (additive).
Experience in a regulated industry (plus).

Skills

Python
Typescript
React
AWS Lambda
AWS Bedrock
AWS Fargate
AWS SQS
AWS RDS
Terraform
PostgreSQL
Drizzle
AI coding tools
Backend architecture
API design
Database management
Scalability
System design
Asynchronous pipelines
Message queues
Container-based compute
Data warehouses
ETL pipelines
External-facing reporting infrastructure
IaC tooling
Clinical data standards (EHR/EMR, HL7/FHIR)

Location

San Francisco, CA

Work Type

Hybrid
Full-time

Experience Level

8 or more years of experience
Staff scope or equivalent impact

Salary/Compensations

$168,000 - $230,000 a year

Benefits

Comprehensive medical coverage for employees and eligible dependents.
Comprehensive dental coverage for employees and eligible dependents.
Comprehensive vision coverage for employees and eligible dependents.
Disability insurance options.
Life insurance options.
Supplemental insurance options.
Flexible paid time off.
Observed company holidays.
One-time home office stipend.
401(k) program.
Pre-tax HSA options.
Pre-tax FSA options.
Commuter benefits.
Financial wellness resources.
Access to legal protection plans.
Pet wellness support (voluntary benefit).
Domestic partner coverage (voluntary benefit).

About the Company

Trial Library is an AI-native research platform with a mission to improve healthcare outcomes by expanding access to precision medicine.
It is an AI-native enrollment and care navigation platform that accelerates access to precision medicine.
In collaboration with biopharmaceutical manufacturers, payers, and health systems, Trial Library enables the delivery of clinical trials as a standard care option.
The platform improves patient access, advances oncology outcomes, and reduces the total cost of care.
Backed by leading healthcare venture capital firms, Trial Library’s platform is currently deployed in 840+ clinics and 3,000+ providers nationwide.
The company offers meaningful impact by helping patients access clinical trials faster through better technology and workflows.
It fosters a high ownership environment with autonomy to build, test, and influence strategy across the business.
Trial Library has a collaborative team culture characterized by low ego, high trust, and close partnership across functions.
It provides an opportunity for growth, joining at an early stage with meaningful exposure to company-building and decision-making.
Core Values: Ally is our favorite moniker; The broadest reach is worth the effort; Celebrate measurable improvements in access and outcomes; Fearless advocates for representation in research; Incentives matter to stakeholders choosing our products; Taking initiative is actually giving; We are accountable for the experience of patients and providers; Empathy and humility are the real dynamic duo.

Equal Opportunity

Trial Library, Inc. is an equal opportunity employer committed to building an inclusive workplace. We provide equal employment opportunities to all employees and applicants and prohibit discrimination and harassment of any kind without regard to race, color, religion, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity or expression, national origin, ancestry, age, disability, genetic information, marital status, veteran status, military status, medical condition, family or medical leave status, political affiliation, or any other characteristic protected by applicable federal, state, or local law.
Trial Library, Inc. is committed to providing reasonable accommodations for qualified individuals with disabilities throughout the recruiting process. If you require assistance or accommodation, please contact jobs@triallibrary.com