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Senior Back-End Engineer - Health Tech (Europe)

🇬🇧 London, United Kingdom Fully remote5+ years
Required Candidate location: Europe

This position is no longer available

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Skills & Languages

Must-have required
Postgresql3 Year(s)Kafka3 Year(s).net3 Year(s)
Languages required
English

About the Role


You will be joining a small, senior engineering team rebuilding a mission-critical care platform from the ground up — event-based, multi-tenant, and agent-ready. The new estate runs on .NET, Kafka, and Postgres, while legacy domains migrate in parallel using a live bridge pattern.

This is not a feature-factory role. The architectural decisions you make in your domain will run for years. You will work closely with operations, clinical, and finance teams to understand how care is actually delivered — then build from there. Audit by default is the architecture, not an afterthought.

The team ships on a modern stack, uses AI coding tools by default, and moves at pace.


This position is available for candidates located and authorized to work in Europe.

Most Important

  • Senior-level .NET / C# — real command of the language and runtime, not just familiarity.
  • Strong domain modelling and DDD experience — you know how to slice complex systems into the right boundaries.
  • Event sourcing, CQRS, and event streaming in production (Akka.NET, EventStore, Marten, Kafka, or similar).
  • Postgres at scale — schema design, performance tuning, multi-tenant patterns.
  • Proven legacy migration experience — you have moved production systems off old foundations with a bridge running in parallel, without breaking the business.
  • Multi-tenant architecture — you understand what makes tenant isolation real versus leaky.

Nice to Have

  • Regulated industry background — health tech, fintech, social care, or defence. Compliance and audit-aware engineering shortens ramp time significantly.
  • NHS-adjacent stack experience — FHIR UK Core, OMOP, SNOMED-CT, GP Connect, DTAC.
  • LLM-powered features in production — evals, drift monitoring, observability.
  • Scheduling, matching, or constraint-solving algorithms at production scale.
  • Command-centre or supervised-automation systems from any domain.

Includes 2 screening questions.

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