About the Job
At Prenuvo, we are on a mission to flip the paradigm from reactive “sick-care” to proactive health care. Our award-winning whole body scan is fast (under 1 hour), safe (MRI has no ionizing radiation), and non-invasive (no contrast). Our unique integrated stack of optimized hardware, software, and increasingly AI, co...
We're looking for a Senior Backend Engineer II to join our Patient Experience team and own the communications platform that keeps patients informed throughout their journey: booking confirmations, appointment reminders, intake nudges, results notifications, and follow-ups across email, SMS, and push. You'll also bui...
Our in-house Python communications service converts event bus domain events into patient messaging via Iterable, AWS SES, SMS, and push. Key challenges involve ensuring reliable, exactly-once delivery, respecting consent and preferences, and gracefully handling vendor failures with detailed logging. We seek engineer...
Key Responsibilities
Own the communications platform: Own the patient communications platform end to end, from design through rollout, including service architecture, on-call standards, and technical roadmap.
Develop complex software solutions: Build and maintain scalable backend services using Python, FastAPI, and AWS event-driven services (EventBridge, SQS/SNS, Lambda, ECS) that power patient communications.
Deliver reliably: Guarantee reliable, exactly-once message delivery through retries and failures, using idempotency, deduplication, backoff, and dead-letter handling and replay, with a clear status for every message we attempt.
Build in consent: Build consent and preference handling into the send path, including channel and category opt-ins, STOP and unsubscribe propagation across systems, quiet hours, and clean separation of transactional and marketing messages.
Make sends safe: Build safe tooling for one-off and bulk patient sends (audience preview, test sends, rate limits, kill switches) with least-privilege access to patient data and vendor credentials, so that a production send is always a deliberate, reviewed action.
Evolve patient-facing APIs: Design and ship OpenAPI-first endpoints that follow our versioning and backward-compatibility standards for mobile clients we can't force-update, and help migrate consumers off legacy GraphQL.
Ensure system reliability: Lead improvements in reliability, observability, and incident response using Datadog. You are accountable for whether a message actually reached the patient, not just whether the code merged.
Raise engineering quality: Write comprehensive automated tests for the services you build, and improve the patterns, tooling, and processes that raise quality across teams.
Provide technical guidance: Lead design discussions, review technical implementations, and mentor engineers across levels.
Influence technical direction: Contribute to architectural decisions and the long-term evolution of the platform, partnering closely with Product, Design, Lifecycle Marketing, Clinical, and other engineering teams.
Use AI-assisted development: Use AI coding tools and agentic workflows thoughtfully as part of a structured build, review, and test workflow.
Required Skills & Abilities
7+ years of backend engineering experience owning production services, ideally in Python (or a similar language such as Ruby, Go, Node.js)
Strong experience designing and building REST APIs, including contract design, versioning, and error handling, in a modern backend framework (e.g., FastAPI, Flask, Django, Express, Spring).
Hands-on experience with cloud platforms such as AWS, including event-driven systems (EventBridge, SQS/SNS, Lambda, ECS), and modern CI/CD practices.
Experience building and maintaining distributed systems and integrating with external APIs and webhooks, including idempotency, retries, rate limits, and partial failure.
Deep knowledge of relational databases, particularly PostgreSQL, plus experience with NoSQL (e.g., DynamoDB) and caching (e.g., Redis).
Experience implementing authentication and authorization (OAuth2, JWT, service-to-service security).
Experience writing comprehensive backend tests (e.g., Pytest) and ensuring strong test coverage.
Experience with monitoring and observability tools such as Datadog or similar platforms.
Ability to independently lead complex initiatives, make sound technical decisions, and balance short-term delivery with long-term maintainability, including on-call and incident response for what you own.
Ability to break down complex projects into components or milestones that other engineers can easily pick up.
Comfortable with ambiguity, able to balance speed with quality, and willing to take ownership from design through production.
Excellent communication skills and the ability to collaborate across engineering and business teams.
Experience with Iterable or a similar customer engagement platform (Braze, Customer.io, Klaviyo, Salesforce Marketing Cloud): event and user-profile APIs, journeys and workflows, message types and channels, and webhook processing.
SMS experience at scale: Twilio or similar providers, 10DLC and short codes, opt-in capture and STOP handling, and TCPA and carrier compliance.
Push notification experience: APNs and FCM (directly or through a platform), device token lifecycle, and deep linking into mobile apps.
Email delivery experience: AWS SES or similar, SPF/DKIM/DMARC, bounce and complaint handling, and suppression lists.
Notification orchestration: multi-channel routing, preference centers, frequency capping, and scheduled or reminder-based messaging.
GraphQL experience, Backend-for-Frontend patterns, or close partnership with native iOS/Android teams.
Familiarity with FHIR or other healthcare data models.
Familiarity with Terraform, Docker, and GitHub Actions.
Experience working in highly regulated industries, including handling sensitive health data.
