Senior Full Stack Engineer-II

Steer Health is an AI-native healthcare engagement platform serving over 360 healthcare organizations and 19 million patients. The role involves owning systems end-to-end across voice AI, healthcare interoperability, event-driven automation, and clinical AI, with a clear path to technical leadership.

Responsibilities:

• Own systems end-to-end - not tickets - across voice AI, healthcare interoperability, event-driven automation, and clinical AI
• Build voice AI pipelines: multi-turn LLM agents, real-time STT/TTS, autonomous outbound calling, and intent resolution at scale
• Create event-driven orchestration: Kafka-powered A2A workflows and multi-step clinical automation across hundreds of healthcare organizations
• Develop healthcare integrations: FHIR R4, HL7 v2.x, and production EHR connections with Epic, athenahealth, and eClinicalWorks
• Implement clinical AI features: SteerNotes AI scribe, scheduling automation, and revenue cycle

Requirements:

• 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 outcomes