Senior Full Stack Engineer (TypeScript/Node.js)-Immediate Joiner

Metric Tree Labs is hiring for our client — a US-based healthcare AI startup founded by Harvard Business School & UC Berkeley alumni. Their platform helps hospitals and clinical research teams find and engage patients for clinical trials: it connects to EHR systems, screens patient records against trial criteria using AI, and powers patient outreach through AI-driven SMS and voice calls.This is a live product on AWS with real customers. You'll work directly with the founder and a small engineering team, owning features end to end — from customer requirements through deployment and production support.What you'll buildProduct workflows for trial setup, patient screening, and eligibility reviewEHR integrations (Epic, eClinicalWorks, athenahealth, OncoEMR) — authentication, bulk exports, recurring syncReliable data pipelines — queues, workers, retries, and failure recovery at scaleAI workflows — document parsing, patient matching, LLM-powered SMS and voice screeningThe stack: TypeScript, Node.js (NestJS), Next.js/React, PostgreSQL (+pgvector), AWS (SQS, ECS Fargate, CDK), FHIR R4/HL7, OpenAI APIs, Twilio, ElevenLabsWhat we're looking for5–6 years building production web applications, with clear examples of features or services you personally ownedStrong TypeScript/Node.js backend skills; hands-on React and Next.jsSolid SQL and data modeling; experience with async processing, queues, or data pipelinesPractical AWS and Docker deployment and debugging experienceAI-native engineer — daily use of AI coding tools (Claude Code, Copilot, Cursor) with the judgment to ship AI-assisted code at production qualityStrong plusesHealthcare software experience — EHR/EMR systems, clinical records, or FHIR/SMART/HL7 integrationsExperience handling PHI within HIPAA or SOC 2 environmentsLLM APIs in production — structured outputs, retrieval, evaluation, cost/latency managementDetails: Full-time, dedicated engagement through Metric Tree LabsRemote · 3–4 hours daily overlap with US Eastern Time