Senior Backend Engineer

## About the Company Spruce is a cloud-based healthcare communications platform that powers clinical workflows for both in-person and remote care. Since launching in 2016, we've grown to support thousands of medical organizations, from solo providers to large multi-site, multi-specialty groups. Our platform spans telemedicine, telephony, secure messaging, team collaboration, and workflow automation. Spruce is widely used—and loved, with a 4.9+ rating across 75K+ reviews—by small- to medium-sized medical practices across the United States. ## About the role As a backend engineer at Spruce, you will work on a fully remote, tight-knit, and lean engineering team with a strong sense of ownership and craftsmanship. You will have significant influence in building and evolving a platform used by both patients and medical providers across the US, and will be expected to make thoughtful tradeoffs in system design while helping shape the evolution of our backend architecture. We're looking for engineers with a strong track record of building high-quality, secure systems. You should be comfortable working on production systems with many moving parts, open to learning new technologies, and excited to contribute across a broad range of backend work, from customer-facing features and internal tooling to data pipelines and system improvements. We value engineers who think holistically, care deeply about the product and user experience, and take ownership throughout the development process. Our backend is written in Go, with services that interact via gRPC. Our client-facing APIs are specified in GraphQL, and we use Terraform to manage our infrastructure on AWS. The systems you build will operate in a high-reliability healthcare environment where correctness, security, and uptime are critical, and where your decisions have real impact on clinical workflows. ## Key Responsibilities - Bring a strong focus on systems engineering, helping to build and operate reliable backend production environments - Design, build, and maintain APIs, services, and infrastructure that power the Spruce platform for medical practices, patients, and internal teams - Write all backend code in the Go programming language - Debug production issues across services and multiple levels of the stack - Participate in code reviews to ensure code quality, maintainability, and scalability - Collaborate cross-functionally to build features that address the needs of both internal and external users - Improve engineering standards, tooling, and processes - Be part of a weekly on-call rotation (every 6 weeks) to troubleshoot customer-facing issues and field escalations from customer-facing teams ## Desired Skills and Experience - 5+ years of experience building and supporting high-quality backend systems, with a strong track record of writing robust, production-grade code - Experience writing production-grade code in Go - Comfortable working across the stack, including devops, systems architecture, user-facing fe