Senior Backend Engineer, Patient Experience

Healthcare is broken at the first step: patients can't find the right care, understand what it costs, or access the medications they need. Mochi Health is fixing this.

We're building an AI-driven marketplace that makes healthcare discoverable—connecting patients to the right providers, transparent pharmacy pricing, and affordable medications. Over the past few years, we've grown rapidly by combining clinical expertise with technology that actually works for real people, not just hospital systems.

Our platform does what legacy healthcare can't: it gives patients transparent pricing before they pay, personalized medication management that follows them across providers, and long-term access to their own medical records. We're proving that healthcare can be more affordable, more human, and far more intuitive than what exists today.

Join a team that's rebuilding healthcare from the patient up. At Mochi Health, you'll work alongside people who value bold thinking, inclusive collaboration, and getting meaningful work into the world. If you want to do the most impactful work of your career, this is where to do it.

$230,000 - $280,000
Full-time / Onsite (5 days/week)

About The Role

We’re looking for a Senior Backend Engineer to help build Mochi’s patient platform — the commerce, clinical, and fulfillment infrastructure that connects patients to medications across a growing number of care categories. Mochi has helped hundreds of thousands of patients lose over 5 million pounds. The backend systems you design will power how the next wave of patients discover medications, qualify for treatment, receive prescriptions, and manage ongoing care.

As a senior member of the engineering team, you will own the design and development of backend systems that power core patient workflows — ordering, billing, prescribing, fulfillment, and subscription management. You will architect systems that support multiple medication types, pharmacy partners, and purchase models, and ensure our infrastructure keeps pace as we expand into new areas of care. Mochi is an AI-first engineering organization — we build with AI tooling, we ship AI-powered automation into our products, and we expect engineers to push both forward.

Healthcare commerce is genuinely complex. A single patient order can involve clinical approval workflows, multi-pharmacy fulfillment routing, subscription billing, and regulatory constraints — and all of it needs to work reliably at scale. If you’re drawn to systems problems where the domain complexity is real and the impact is tangible, this is that role.

What You’ll Do

• Own the backend systems that power medication ordering and fulfillment — from the moment a patient selects a medication through clinical approval, pharmacy routing, and delivery, across multiple pharmacy partners and fulfillment channels
• Build and evolve subscription and billing infrastructure that supports multiple purchase models, payment recovery, and pricing that varies by pharmacy and medication type
• Design the data models and domain architecture that underpin ordering, prescribing, and clinical workflows — ensuring they generalize cleanly as Mochi expands across care categories
• Architect the systems that connect clinical workflows to the patient experience — health checks, prescribing approvals, and medication management that work across different treatment categories, with AI-assisted automation where it can improve speed, accuracy, and patient outcomes
• Collaborate with Product, Clinical, and Operations teams to translate healthcare and regulatory requirements into backend systems that are reliable, auditable, and maintainable. Own key architectural decisions, mentor engineers, and raise the engineering bar through code review, testing practices, and technical standards — including how the team uses AI tooling to ship faster and with more confidence

Who You Are

• 5-7+ years of backend engineering experience. You’ve built and operated production systems that handle real complexity — not just traffic, but complex domain logic, stateful workflows, and integration with external partners
• You get data modeling right. You think carefully about schema design, state transitions, and domain boundaries, because you’ve seen what happens downstream when the model is wrong
• You build things that run in production, not just pass review. You care about observability, failure modes, and what happens at 2 AM when something breaks. You’ve debugged systems under pressure and improved them afterward 
• You ship end to end — from scoping and design through deployment and monitoring. You take ownership of outcomes, not just code
• You’re already using AI tools to build faster and you’re excited about pushing that further — whether that’s agentic devel