Senior Software Engineer (Infrastructure)

Counsel’s mission is to multiply the world's healthcare capacity. We believe in a future in which every person has a personalized, AI-enabled doctor always in their pocket. To accomplish this, we’re building the first fully-vertical, AI-native medical group from the ground up. We’ve redesigned the entire clinical stack with custom AI tools that make our in-house physicians 10x faster and smarter. [more info]

Since our founding in 2023, we have formed partnerships with leading healthcare organizations and are on track to serve hundreds of thousands of patients on our platform within the next year. We have raised over $35M from a16z and other top-tier VC firms, and on pace to 5x revenue this year.

Our founding team includes experienced clinical and technology leaders from Harvard Medical School, Massachusetts General Hospital, UCSF, the MIT Media Lab, and Mount Sinai. Our small but stellar engineering team (ex-Stripe, NVIDIA, Google DeepMind) is growing fast — and we’re looking for exceptional people to join us at this inflection point.

Join us as we build the future of AI in healthcare!

We are seeking a talented, driven, and experienced Senior Infrastructure Engineer to join us in defining the future of AI + human healthcare. This role is fully remote.

You will have significant responsibility and ownership over our infrastructure, along with the opportunity to shape the future of our engineering/infra organization. This role is central to ensuring our platform can scale seamlessly—meeting the demands of large healthcare clients while reliably serving hundreds of thousands of patients. Our culture is fast-paced and ambitious, and we aim for every team member to be exceptional.

• Scale our infrastructure and deployments, meet the demands of hundreds of thousands patients maintaining fast response time and 99.99% uptime.

• Plan and lead key infrastructure investments, ensuring we can scale while balancing short-term delivery with long-term maintainability

• Drive development of core data infrastructure, including our data transformation and warehouse systems, integrations with health information networks, and data ingestion pipelines with enterprise clients

• Improve developer experience and engineering velocity, building the tooling, CI/CD pipelines, and observability systems that let teams move faster with confidence

• Champion operational and security excellence, including reliability, monitoring, on-call practices, and infrastructure security aligned with healthcare standards (HIPAA, SOC2)

• Optimize our Kubernetes clusters and services to meet the demands of our scaling services

• Plan and lead a migration of our critical queue workflows in SQS onto Temporal

• Re-imagining our release operations workflows to streamline QA tested changes directly into production

• Design and lead our multi-tenant isolation and row-level encryption strategy for sensitive enterprise client data

• 5+ years building production software, with 2+ years deploying production systems in a cloud environment.

• Proven experience building infrastructure that handles millions of requests with strict uptime and latency requirements

• Proficiency with Terraform or similar tools for automated infrastructure management

• Proven experience with:

  • Secure container deployment and Kubernetes best practices on AWS EKS

  • Large-scale SQL databases (e.g. PostgreSQL, MySQL)

  • Real-time queue systems (e.g. Kafka, SQS, Temporal)

• Opinionated about improving developer experience through tooling, automation, and workflows that accelerate and up-level the engineering team around you

• You have experience with our tech stack: AWS, Terraform, TypeScript, Redis, Node, Postgres

• You consider yourself a swiss army knife engineer who can flex into infrastructure problems related to backend services, data pipelines, and web products.

• You care deeply about performance and feel immense satisfaction driving latency of critical services down

• You bring an SRE’s toolkit of experience, with strong opinions on how to invest in on-call and incident management practices to ensure system reliability.

• You have hands-on experience scaling early systems from 1 → 10 in a fast-paced, high-growth environment

• You thrive on working alongside exceptional teammates and derive energy from collaborative environments

• Impact: Be at the forefront of AI-augmented care delivery, tackling some of the most ambitious challenges in healthcare.

• Growth: Professional development and leadership opportunities within a rapidly expanding tech-enabled care delivery organization.

• Exposure: Gain hands-on experience in scaling a fast-growing healthcare technology company and directly interface with executives at the world’s leading healthcare organizations.

• Compensation: Competitive salary and equity options.

• Benefits: Competitive healthcare, vision, and dental, snacks and free lunch at the office.