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[Remote] Senior Backend Engineer (Python)

Remote-first Full-time Now hiring

Note: The job is a remote job and is open to candidates in USA. Ellipsis Health is developing cutting-edge AI/ML products to address healthcare staffing issues and administrative burdens. The role involves expanding and maintaining real-time voice pipelines and collaborating cross-functionally to deliver innovative features for conversational AI.

Responsibilities

  • Expand and maintain our real-time voice pipeline: design, implement, and maintain Python micro-services for conversational AI orchestration—audio capture, streaming transcription, prompt/LLM logic, synthesis, and playback
  • Integrate new providers & transports: add plug-ins for emerging ASR, TTS, LLM, and memory services; wire up WebRTC, SIP, or phone endpoints; build adapters that allow hot-swapping components without downtime. Build API endpoints
  • Deliver ultra-low latency (
  • Instrument & observe every hop: emit structured traces (OpenTelemetry), metrics, and logs for each pipeline stage; define SLOs for first-token latency, end-to-end latency, and streaming reliability
  • Harden for production: implement graceful retries, idempotent message passing, circuit breakers, and HIPAA-compliant security (encryption in transit, per-tenant isolation, secrets rotation)
  • Collaborate cross-functionally with ML, product, data engineering, and client-SDK teams to deliver features such as voice cloning, multimodal hand-offs, and domain-specific memory retrieval

Skills

  • 4+ years building production back-ends in modern Python
  • Proven experience with real-time streaming systems—WebRTC, WebSockets, or gRPC streaming—and proficiency with asyncio, FastAPI, or similar async frameworks
  • Deep understanding of concurrency, buffering, audio codecs (Opus, PCM), and distributed tracing
  • Solid understanding of AWS/GCP/Azure, including container orchestration (Kubernetes/EKS/GKE), message queues (Kafka/SQS/Pub/Sub), and IaC (Terraform)
  • Solid grasp of relational (PostgreSQL) and in-memory (Redis) data stores; able to model and persist conversational state
  • Excellent communication skills and a bias for measured, observable, and continuously deployable software
  • B.S./M.S. in CS, EE, or related fields
  • Familiarity with voice-agent frameworks
  • Hands-on with telephony (Twilio, Telnyx), SIP, or PSTN integrations
  • Experience integrating multimodal inputs (vision, text chat) into voice agents
  • Familiarity with GPU inference and streaming pipelines
  • Prior work in regulated industries (healthcare, finance) and comfort preparing for SOC 2 / HIPAA audits

Benefits

  • 401k matching up to a certain percentage of your salary
  • Health, vision, and dental insurance
  • Very flexible paid time off

Company Overview

  • AI Nursing Care Manager It was founded in 2017, and is headquartered in San Francisco, California, USA, with a workforce of 11-50 employees. Its website is http://www.ellipsishealth.com.
  • Company H1B Sponsorship

  • Ellipsis Health has a track record of offering H1B sponsorships, with 2 in 2026, 6 in 2025, 1 in 2024, 2 in 2023, 1 in 2021. Please note that this does not guarantee sponsorship for this specific role.
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