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Senior Back End Engineer
Fresno, CAMarch 28th, 2026
Compensation$170k-$225k0.17%-1.04%TLDRWe are growing fast, profitable, and need to hire a Founding Back End Engineer ASAP. This role is focused on selling Neon’s automation platform to healthcare and life sciences organizations, owning the full sales cycle from prospecting through close. Ideal candidates have enterprise SaaS sales experience, thrive in high-growth environments, and are motivated to build a category-defining company. You should have at least 4 years of experience.Our MarketThe crisis: Sarah delayed cancer treatment for weeks facing massive monthly costs. Marcus's autoimmune condition worsened while battling insurance denials.Over 50% of critical prescriptions are abandoned due to:Cost barriers: Patients with high copays are 5x more likely to abandon treatmentInsurance maze: Complex prior authorizations block accessLogistical challenges: Coordinating medical visits for treatmentsNeon's technology eliminates these obstacles by automating patient access workflows for pharma companies: —automating authorizations, streamlining benefits verification, and unlocking financial assistance.Why Join?Frighteningly ambitious: We’re seasoned builders on a mission to create a $200B+ company—on the scale of Palantir or ServiceNow—serving the largest healthcare enterprises.Experienced founding team: Built by exited founders, YC & MIT alum, ex-Tesla, ex-Google engineers.Hypergrowth with stability: We went from initial idea to 7+ figure customer contracts in just 4 months—in an industry where sales cycles typically take 12-18 months. We are profitable and relentlessly focused on execution.Powerhouse backing: We’re funded by elite Silicon Valley VCs who've backed unicorns like DoorDash, Lyft, and Mammoth Biosciences. And strategic healthcare investors with deep industry connections.Outsized impact & opportunity: Work at the intersection of agentic AI, healthcare transformation, and life-changing patient outcomes.Required SkillsTechnical skills:Proficiency with Node, Typescript, and Python.Good understanding of system design concepts - distributed systems, reliability/performance tradeoffsExperience in API design, implementation, and documentationExperience using AI coding tools (Cursor, Github Copilot, Claude, etc)Experience working with CI/CD systems and good DevOps skills a nice to haveExcellent documentation and testing habitsProficiency with version control (Git)Soft skills:10x mindset - you’ll be among the first engineering hires!You are a fun human!Good time management and planning skillsExperience4-7 years of experience (or equivalent) as a software engineer.We’re leveling this role to Pave’s “P4” level: Leads project teams, provides direction, and keeps stakeholders informed. Determines key milestones and provides updates and check-ins to relevant teams and partners.You are able to work with the rest of the team to:Define prioritiesSuggest good solutionsExcel at implementationYou pick up concepts quickly, pattern match on past problems.You are obsessed with speed and quality, and help embed that quality into the rest of the team.You are self-directed, and do not need help organizing / prioritizing your time.Specific project experienceNice if you have worked on distributed architectures in the past, but not a strict requirement.You must have experience working on projects touching many parts of a large codebase.
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