Senior Backend Engineer, Ambient AI

At Commure, we're building the AI Operating System for healthcare, the foundation that defines how care is delivered, documented, and financed. Our platform spans the full care journey: Ambient AI and Dictation eliminating documentation burden at the point of care, intelligent Agents automating patient and revenue workflows, and autonomous RCM processing billions in claims, all on a single AI-native platform integrated with 60+ EHRs.

Healthcare carries a $1 trillion administrative burden and we're at the center of transforming it. Today, 500,000+ clinicians across 500+ healthcare organizations nationwide trust Commure to handle $25B+ in annual claims and support over 200 million patient interactions. Our latest $70M raise at a $7B valuation reflects the confidence the market has placed in this mission. We've also been named to the Fortune Future 50 list and the 2026 AI Breakthrough Awards for “Overall NLP Company of the Year.”

Our team works directly alongside clinicians, not through layers of process, which means the gap between what you build and its impact on patient care is immediate. We move fast, deploy daily, and take full ownership from early thinking to production. If you're energized by hard problems, high stakes, and a team that holds itself to a high bar, you'll find your people here.

The future of healthcare is being built right now. Come deliver this transformation.

About the Role

We’re building a next-generation ambient AI platform for healthcare, helping clinicians focus on patient care by automatically capturing, understanding, and structuring clinical conversations.

Behind that experience is a distributed system responsible for ingesting long-form audio, processing real-time and asynchronous streams, orchestrating multiple AI models, and reliably producing clinical outputs. These workflows must remain observable and recoverable across network interruptions, partial failures, model timeouts, and rapidly changing inference infrastructure.

We’re hiring a Backend Engineer to help build and operate this foundation. You’ll work across audio ingestion, media processing, inference orchestration, distributed workflows, storage, observability, and cloud infrastructure.

This role is ideal for an engineer who enjoys making complex systems dependable. You think carefully about failure modes, idempotency, backpressure, data integrity, latency, and operational simplicity. You also understand that infrastructure exists to serve the product: the systems you build must ultimately create a fast, reliable, and trustworthy experience for clinicians.

What You’ll Do

- Design, build, and operate backend systems that power our Ambient AI products across mobile and web.

- Own critical parts of the audio processing lifecycle, including:

- Real-time and asynchronous audio ingestion

- Streaming and chunked uploads

- Audio validation, encoding, normalization, and processing

- Durable storage and media lifecycle management

- Recovery from interrupted, duplicated, delayed, or out-of-order uploads

- Build and evolve inference workflows that coordinate transcription, diarization, language models, clinical extraction, summarization, and other AI capabilities.

- Develop orchestration systems for long-running, multi-stage workflows, including:

- Scheduling, queueing, and workload prioritization

- Retries, timeouts, fallbacks, and dead-letter handling

- Idempotency, replay, and safe workflow recovery

- Model routing, versioning, and configuration

- Progress tracking and user-visible workflow state

- Graceful degradation when dependencies are unavailable

- Improve the reliability and scalability of services operating under variable, compute-intensive workloads.

- Define and maintain service-level objectives for critical workflows, including availability, processing latency, completion rates, and data durability.

- Build strong observability across services and pipelines through structured log …