Senior Backend Architect in at Revelation Pharma LLC
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Job Description
Evergreen Telehealth · Remote (U.S.)
Evergreen Telehealth is a vertically integrated direct-to-consumer telehealth platform under Revelation Pharma Corporation — a PCAB-accredited, ASHP-accredited, LegitScript-certified compounding pharmacy group. We are building Grove, which is a transactional healthcare system — real prescriptions, real clinical workflows, real patients — and the backend is where everything that matters actually happens.
We are hiring a Senior Backend Architect to own the design and integrity of Grove’s backend transaction systems, data flows, and integration layer. This is an architect-practitioner role — you design the systems and you build them. You will define how data moves across the platform: from patient intake through clinical decision support, FHIR resource persistence, prescription dispatch, and AI agent orchestration. You will set the backend architecture standards that the KMS Technology engineering team executes against, and you will be the final authority on how Grove’s transaction systems are designed, integrated, and scaled.
The ideal candidate has spent meaningful time architecting backend transaction systems at scale, has recent hands-on experience wiring agentic AI flows into production backend infrastructure, and understands what it takes to operate ML pipelines in a production healthcare environment. You know what a well-designed event-driven system looks like — and you know where the bodies are buried when it isn’t.
- Backend transaction system architecture — end-to-end data flow design across patient intake, clinical workflow, prescription dispatch, and care plan execution
- FHIR R4 resource modeling and persistence — AWS HealthLake ingestion pipelines, resource lifecycle management, query optimization, and FHIR API contract design
- Agentic AI integration architecture — designing the backend infrastructure that supports Grove’s six AI agents, including context management, tool-call orchestration, state handoff, and guardrail enforcement at the transaction layer
- ML pipeline operations — infrastructure and data flow support for model training pipelines, feature stores, inference endpoints (AWS Bedrock, SageMaker), and model output integration into clinical workflows
- Event-driven architecture — EventBridge / Lambda orchestration patterns for async clinical workflows, including prescription routing, refill logic, and care plan state transitions
- PrescriptionDispatchService — the abstraction layer routing prescriptions between Innovation Compounding (LifeFile direct webhook integration), DoseSpot/SureScripts (Phase 2), and HiveRx (Phase 2)
- Canvas Medical EHR integration — backend data synchronization, webhook handling, clinical workflow mapping, and FHIR resource exchange with the EHR layer
- Backend integration contracts — API design, schema governance, versioning strategy, and integration standards across all Grove service boundaries
- Infrastructure architecture — AWS service design (IAM, VPC, RDS/Aurora, API Gateway, S3, Cognito) with a security-first, HIPAA-compliant posture
- Technical leadership of the KMS Technology engineering team on backend deliverables — architecture reviews, design docs, code review standards, and PR approval authority
- 5+ years of backend systems architecture experience — you have designed and shipped production transaction systems at scale, not just contributed to them
- Recent hands-on experience architecting agentic AI or LLM-integrated backend systems — tool use, multi-step agent orchestration, state management, or prompt/response pipelines wired into production infrastructure
- ML pipeline experience in a production environment — feature engineering pipelines, inference infrastructure, or model-serving integration; you understand the data flow from raw signal to model output to downstream system
- AWS-native backend expertise — Lambda, EventBridge, API Gateway, RDS/Aurora, S3, IAM, Cognito; you design for AWS, not around it
- FHIR R4 implementation experience — hands-on resource modeling and API work in a production system; clinical familiarity with Patient, MedicationRequest, Observation, CarePlan, and related resources
- Event-driven architecture fluency — async workflow design, idempotency, dead-letter handling, saga patterns, and distributed transaction management
- HIPAA-compliant architecture — PHI data handling, encryption at rest and in transit, audit logging, and access control in production healthcare systems
- Strong TypeScript and/or Python; Node.js Lambda experience required
- AWS HealthLake production experience — direct work with FHIR-native data stores at the infrastructure level
- Canvas Medical or equivalent EHR integration (Athenahealth, Epic FHIR APIs) in a backend engineering context
- Experience designing Markov-model or probabilistic state machine architectures in a clinical or behavioral context
- AWS Bedrock experience — agent framework, knowledge base integration, or model invocation pipelines
- Compounding pharmacy or e-prescribing system integration — DoseSpot, SureScripts, LifeFile, or equivalent
- SOC 2 Type II audit preparation or equivalent compliance engineering experience
- Experience as the backend architecture authority on a team that includes an offshore development partner