Senior Telephony Infrastructure Engineer jobs in United States
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PatientNow · 1 day ago

Senior Telephony Infrastructure Engineer

positionBrooklyn, NY
timeFull-time
remoteOnsite
senioritySenior Level
date5+ years exp

PatientNow is a company focused on elevating businesses in the beauty, wellness, and medical aesthetics sectors through innovative software and consulting solutions. The Senior Telephony Infrastructure Engineer will own the real-time communications layer for the Recura product line, responsible for building and operating telephony systems and ensuring their reliability and compliance.

AssociationHealth CareSoftware

Responsibilities

Design, implement, and operate SIP-based voice infrastructure and WebRTC calling
Build and maintain call routing systems including schedules, ring groups, IVR, voicemail, and overflow logic
Design timezone-aware, rules-based routing, including overnight ranges and day-of-week matching
Implement missed-call, abandoned-call, and after-hours detection with deterministic, idempotent event emission
Own SMS/MMS carrier integrations, including A2P 10DLC registration workflows and enforcement
Build and maintain ISV-style subaccount onboarding, including phone number provisioning and messaging service assignment
Implement answering machine detection (AMD) with async callbacks and configurable detection behavior
Design VoIP observability systems for call session tracking, event correlation, and production debugging
Handle phone number lifecycle operations, including migration between messaging services with rollback safety
Mentor engineers on reliability, event-driven design, and debugging complex production systems

Qualification

SIP-based callingWebRTCCall routing systemsA2P 10DLC complianceTelephony systemsEvent-driven systemsISVMulti-tenant CPaaSModern backend systemsBusiness ethicsProblem solvingTeamworkAdaptabilityContinuous learningCommunications

Required

5+ years of experience building or operating telephony, VoIP, or CPaaS systems
Hands-on experience with SIP-based calling and WebRTC in production environments
Experience building call routing systems (schedules, ring groups, IVR, overflow logic)
Experience implementing A2P 10DLC compliance workflows, including brand/campaign lifecycle handling
Experience with ISV or multi-tenant CPaaS models, including subaccount provisioning
Strong understanding of event-driven systems, webhook retries, and idempotent processing
Familiarity with result-based error handling patterns (explicit success/failure states over exceptions)
Prior startup experience

Preferred

Familiarity with modern backend systems (e.g., TypeScript, Postgres) and cloud infrastructure

Company

PatientNow

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patientNOW is EMR, practice management, and patient engagement software for aesthetic medical practices.
dateFounded in 2004
location
Greenwood Village, Colorado, USA
people-size201-500 employees
web-link
http://www.patientnow.com

Funding

Current Stage
Growth Stage
Total Funding
unknown
2020-01-01Private Equity

Leadership Team

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Bethany Little
Chief Executive Officer
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Recent News

globallegalchronicle.com
PatientNow Acquires Recura AI to Enhance Medical Spa Software Offerings
2025-11-14
PR Newswire
PatientNow Acquires Recura, the AI Growth Engine Powering Practice Growth
2025-10-30
MedCity News
The Top Appointment Scheduling Software for Wellness Clinics
2025-08-08
Company data provided by crunchbase