Senior Full-Stack Engineer

About Kouper Health

Kouper is redefining how care transitions happen. Backed by General Catalyst, CVS Health Ventures, 25madison, and leading health system partners, we're on a mission to bridge the care transition gap and fundamentally improve the patient experience — helping people live longer, healthier lives.

Why This Role Is Exciting

As a Full Stack Engineer specializing in MLOps and backend systems, you'll be at the forefront of applied large language model (LLM) development and backend connectivity. Working closely with the Chief Technology Officer (CTO) and collaborating with product, operations, and clinical teams, you'll build the infrastructure that powers real-time patient engagement and drives better healthcare outcomes.

You'll architect scalable backend services and ML deployment pipelines that bring together fragmented healthcare data into a seamless patient experience. In our fast-paced, mission-driven startup environment, you'll see your work directly impact patients' lives while helping shape a culture centered on innovation, collaboration, and compassion in healthcare.

• Design, develop, and maintain scalable backend services, and APIs that support our AI-driven patient engagement platform
• Build and maintain the infrastructure for deploying, monitoring, and LLM-driven applications in production environments
• Collaborate closely with AI/ML engineers to architect systems that seamlessly integrate conversational AI and predictive models into our platform
• Lead the design of scalable, extensible backend architectures that can evolve with our product capabilities and growing data requirements
• Implement CI/CD pipelines for our application, including automated testing, versioning, and deployment strategies
• Build reusable code libraries, components, and frameworks to improve development speed and quality
• Implement engineering best practices for secure, scalable, and maintainable code
• Leverage cloud services (GCP, Azure, AWS) to build cost-effective, scalable infrastructure for both traditional web services and ML workloads
• Participate in code reviews and help establish development standards
• Troubleshoot, debug, and resolve issues, ensuring high availability and performance
• Work with product, operations, and clinical teams to translate business requirements into technical solutions

• 5+ years of experience in full stack development, with at least 2 years in a senior level role
• Early-stage product experience building from 0 to 1, and rebuilding that 1 into N
• Proficiency in Node/Python stack, RDBMS, ReactJS, Express
• Strong interest in AI with hands-on experience integrating LLMs into production systems, or strong willingness to learn
• Excellent system architecture skills with experience designing extensible, scalable backend systems
• Disciplined approach to design and engineering: Clean Code, TDD, CI/CD
• Experience working with cross-functional and non-technical business stakeholders and partners
• A portfolio of projects where you led engineering efforts

• Experience in healthcare tech or related industries
• Familiarity with DevOps practices, containerization (e.g., Docker), and orchestration (e.g., Kubernetes)
• Experience with AI model deployment platforms, A/B testing, and monitoring tools
• Background in mentoring and coaching engineering teams

• Competitive salary and equity package
• Flexible work environment and remote options
• Comprehensive health, dental, and retirement benefits
• The chance to make a significant impact in a mission-driven startup focused on transforming patient care
• Location: NYC, SF, or Remote
• Expected Start Date: Oct/Nov 2025