Job Description

Gramian Consultancy is a boutique consultancy specializing in IT professional services and engineering talent solutions. With a strong background in software engineering and leadership, we help companies build high-performing teams by matching them with professionals who truly fit their needs.
Role Overview
We are supporting a cutting-edge healthcare technology initiative and are seeking a Senior Backend + AI Engineer with strong experience across backend development, healthcare data workflows, and applied AI/semantic search. This role is ideal for someone who can own complex technical decisions, work directly with founders, and deliver high-impact features in a regulated environment.
Commitments Required: 8 hours per day with an overlap of 4 hours with PST.
Employment type: Contractor assignment (no medical/paid leave); 100% REMOTE
Duration of contract: 4+ months with the possibility of transitioning into a full-time role upon successful delivery.
Locations: LATAM, EMEA, Asia
Interview: Technical Assessment, Technical Interview, Cultural Interview
Responsibilities
You will lead the backend and AI components of a new, HIPAA-compliant clinical intelligence platform in the urology domain. The product ingests data from Electronic Health Records, performs advanced semantic search over structured and unstructured clinical content, and supports workflow automation for medical teams. This is a greenfield build, offering the rare chance to architect foundational systems from scratch alongside the founder.

• Build and maintain secure data ingestion pipelines for healthcare data (FHIR and clinical formats).
• Normalize medical data using ICD-10, CPT, SNOMED CT, LOINC, RxNorm.
• Design and implement EHR integrations and external API connections.
• Architect backend services, multi-tenant PostgreSQL databases, and HIPAA-compliant infrastructure.
• Develop semantic search, NLP-driven querying, and relevance-ranking features.
• Implement RBAC, audit logging, encryption, and other security controls.
• Integrate third-party services (OAuth, communication tools, notifications).
• Create automated monitoring, data synchronization, and operational health checks.
• Collaborate with clinical advisors to refine domain-specific capabilities.
• Produce clear technical documentation and support compliance needs.

Requirements

• 5+ years building production-grade backend systems.
• Background working with healthcare datasets, FHIR standards, or EHR integrations.
• Hands-on experience with semantic search, NLP pipelines, or text-based data retrieval.
• Strong SQL expertise: schema design, indexing, optimization, and secure multi-tenant architectures.
• Experience designing secure systems handling sensitive or regulated data (HIPAA, GDPR, SOC2).
• Integration work with REST APIs, OAuth, and external third-party services.
• Ability to own decisions around architecture, design, and performance.

Nice-to-Have

• Prior involvement in medical or clinical software products.
• Familiarity with vector databases, RAG setups, or LangChain.
• Hands-on experience integrating with major EHR platforms (Epic, Cerner, Athena, etc.).
• Exposure to cloud infrastructure, Docker, CI/CD, observability tools.
• Experience building or optimizing search-heavy applications.

Skills Required