Ambience Healthcare · 15 hours ago
Staff Software Engineer, Distributed Systems
San Francisco, CA
Full-time
Hybrid
Senior Level, Lead/Staff
$250K/yr - $300K/yr
7+ years expAmbience Healthcare is the leading AI platform for documentation, coding, and clinical workflow, built to reduce administrative burden and protect revenue integrity at the point of care. The role involves owning core systems for database architecture, caching, and performance optimization to ensure reliable clinical workflows across major health systems.
Artificial Intelligence (AI)Health CareInformation TechnologyMedical
Responsibilities
Database Architecture & Scaling — Own database performance end-to-end: query optimization, indexing strategy, connection management, capacity planning. Design multi-tenant data patterns that maintain performance while balancing isolation tradeoffs
Caching & Latency Optimization — Build caching infrastructure that keeps EHR API latency out of critical user paths. Identify and optimize hot paths across the application. Build instrumentation to catch performance regressions before they reach users
Rate Limiting — Design systems that respect EHR API rate limits while maintaining user experience. Build infrastructure that degrades gracefully under load: queue management, circuit breakers, load shedding
Reliability & Observability — Dashboards and alerting for database performance, cache hit rates, connection pool utilization, API latency by customer. Systematically identify and harden against failure modes: connection exhaustion, cache stampedes, thundering herds
Qualification
Required
7+ years in software engineering, 3+ focused on infrastructure, backend systems, or platform engineering
Staff-level scope: owned cross-cutting infrastructure, debugged production issues that stumped others
Strong backend fundamentals in Python, Go, TypeScript, or similar
Deep experience with relational databases (Postgres preferred)
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
Benefits
Health, dental, and vision coverage
Quarterly retreats
Unlimited PTO
401(k) plan with matching
Company
Ambience Healthcare
Ambience Healthcare develops an AI operating system used for documentation, coding, and clinical workflows in healthcare organizations.
201-500 employees
H1B Sponsorship
Ambience Healthcare has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (4)
Funding
Current Stage
Growth StageTotal Funding
$319.29M2025-07-29Series C· $243M
2024-02-06Series B· $70M
2022-04-25Series A
Leadership Team
Nikhil Buduma
Co-Founder & CEO
Michael Ng
President & Chairman
Recent News
2026-01-10
Precedence Research
2025-12-04
Company data provided by crunchbase