Staff Software Engineer, Distributed Systems

The role

You will own core systems including database architecture, caching, multi-tenancy, and performance optimization. You will design infrastructure to handle growth and ensure reliability for real-time clinical workflows.

What you will do

• Own database performance including query optimization, indexing, and capacity planning
• Design multi-tenant data patterns
• Build caching infrastructure to manage EHR API latency
• Identify and optimize hot paths across the application
• Build instrumentation to catch performance regressions
• Design systems to respect EHR API rate limits
• Build infrastructure for queue management, circuit breakers, and load shedding
• Create dashboards and alerting for database performance, cache hit rates, and API latency
• Identify and harden against failure modes like connection exhaustion and cache stampedes

Required qualifications

• 7+ years in software engineering
• 3+ years focused on infrastructure, backend systems, or platform engineering
• Staff-level scope owning cross-cutting infrastructure
• Experience debugging production issues that stumped others
• Strong backend fundamentals in Python, Go, TypeScript, or similar
• Deep experience with relational databases
• Comfort reading code across the stack to trace performance issues
• Track record of diagnosing and solving scaling or reliability problems
• In SF, 3x/week in-person

Nice to have

• Postgres

Benefits

• Comprehensive medical, dental, and vision coverage for you and your dependents
• 401(k) with a company match of up to 3% of base salary
• Full equipment provisioning
• Parental leave
• Annual company-wide off-sites, team off-sites and regular team lunches and all-hands gatherings with travel, lodging and meals covered
• Flexible time off with no annual cap
• Company-wide holidays
• Annual holiday shutdown from December 24–January 1

About the company

Ambience builds an AI intelligence platform that restores humanity to healthcare by removing administrative burden. The company provides real-time coding-aware documentation and clinical workflow support across North America.