We are seeking an experienced Senior Backend Engineer (TypeScript/Node.js) to join our team and hit the ground running on our Okeiro healthcare platform - a comprehensive patient management and clinical workflow solution built with a modern TypeScript stack. You'll be working on a mission-critical healthcare application handling sensitive medical data, diagnostic reports, prescriptions, and patient monitoring. This role requires someone who can independently architect solutions, mentor team members, and deliver high-quality backend services in a complex healthcare domain. The ideal candidate brings deep expertise in TypeScript, PostgreSQL, GraphQL, and modern backend patterns, with a strong understanding of clean architecture principles and the ability to navigate healthcare-specific data models and regulatory requirements.

Required Qualifications:

• 5+ years of hands-on experience with TypeScript and Node.js in production environments
• Deep expertise in TypeScript advanced features (branded types, discriminated unions, generics, utility types, strict mode, exhaustive pattern matching)
• Strong PostgreSQL experience with complex queries, schema design, migrations, indexing strategies, transactions, and performance optimization
• Proven GraphQL API development experience (schema design, resolvers, DataLoader patterns, query optimization, error handling)
• Hands-on ORM experience (Drizzle preferred, or Prisma/TypeORM with willingness to adapt quickly)
• Solid understanding of Clean Architecture / Domain-Driven Design principles and practical application in production systems
• Experience with monorepo architectures (Turborepo, Nx, or similar) and package management (Yarn workspaces, pnpm)
• Proficiency with Docker and containerized development workflows (multi-stage builds, Docker Compose, orchestration)
• Strong Git practices with structured commit conventions and collaborative workflows
• Demonstrated ability to work independently, make architectural decisions, and drive technical initiatives
• Security-conscious mindset with understanding of protected health information (PHI) sensitivity
• Clear, proactive communication skills and ability to collaborate across technical and non-technical stakeholders
• French: C2 level
• English: C2 level

Preferred Qualifications:

• Healthcare/HealthTech experience with FHIR standards, HL7 protocols, or HIPAA compliance concepts
• Familiarity with medical terminology systems (SNOMED CT, LOINC, ICD-10, ATC classification)
• Experience with Hono.js or similar lightweight frameworks (Express, Fastify, Koa)
• Hands-on experience with BetterAuth, Auth.js, Passport, or similar authentication libraries (JWT, multi-realm auth, session management)
• Background job processing experience with pg-boss, BullMQ, or similar queue systems
• Graph database experience, particularly Neo4j for semantic/knowledge graphs
• Google Cloud Platform services experience (Cloud Storage, Pub/Sub, Cloud Functions)
• Event-driven architecture and event sourcing patterns
• French healthcare regulatory knowledge (CNIL, HDS certification, ISO 62304, RGPD)
• PDF generation for medical documents (PDFKit, Puppeteer)
• Firebase/FCM for push notifications
• SMS/Communication APIs (Twilio, similar platforms)
• Experience with Zod or similar runtime validation libraries
• Testing expertise (Jest, Vitest) with unit, integration, and e2e testing strategies
• CI/CD pipelines (GitHub Actions, GitLab CI) and DevOps practices
• Experience in startup or fast-paced healthcare environments
• Contributions to open-source projects or technical writing

What We Offer:

• Alan Health Insurance
• Gymlib (wellness club) membership
• Comprehensive benefits package
• Flexible working hours and remote work options
• Opportunities for professional growth and development
• A collaborative and inclusive work environment
• Access to the latest development tools and technologies
• Opportunity to work on meaningful healthcare technology that directly impacts patient care
• Autonomy to make architectural decisions and influence technical direction