Senior Backend - Focused Fullstack Engineer

We are seeking a Senior Backend-Focused Full-Stack Engineer to join a high-growth US-based technology company building a multi-tenant case management and telehealth platform. You will act as a 0-to-1 core builder, architecting scalable backend microservices, complex healthcare/insurance workflows, resilient payment engines, and third-party integrations. This is a senior, high-ownership role on a remote-first team where you will design systems, drive engineering standards, and build scalable infrastructure from scratch.
Responsibilities:
Backend Architecture: Design, build, and operate backend services in a modular-monolith / microservices architecture using Node.js, TypeScript, and Apollo GraphQL.
Multi-Tenant Data Layer: Model and evolve relational database schemas in PostgreSQL with Prisma 7 with heavy attention to query optimisation, indexing, and data integrity.
Third-Party and Payment Integrations: Build and harden payment gateways (Stripe, NMI), communication APIs, and healthcare webhooks with strict idempotency, rate-limiting, and error handling.
Event-Driven Workflows: Design asynchronous pipelines and background jobs (Pub/Sub, scheduled cron tasks) for payment retries, escalations, and automated batch processing.
End-to-End Ownership: Wire up Vue 3 / React frontend interfaces with GraphQL resolvers to ship features completely end-to-end.
Technical Leadership: Lead technical design discussions, mentor junior engineers, and drive code quality and observability.
Requirements:
4-12 years of experience in backend/full-stack engineering roles at medium-to-large-scale production systems.
Deep expertise in Node.js, TypeScript, and GraphQL API design.
Strong relational database experience with PostgreSQL / Prisma (indexing, query tuning, migrations).
Demonstrated ability to handle scale, payment webhooks, and asynchronous message queues.
Sufficient frontend competence in Vue 3 or React to own features end-to-end when required.
Exceptional written and verbal communication skills for a remote, async-first team culture.
Key Highlights and Operating Model:
Role Weight: 70-80% Backend Engineering / 20-30% Frontend Engineering.
Experience Required: 4 to 12 years.
Work Setup: 100% Remote (Work from anywhere in India).
Shift Timings: 3:00 PM - 12:00 AM IST (Aligning with US-based core engineering team).
Employment Type: Full-time permanent engineering role.
Target Candidate Profile (Strict):
Mindset: Ex-Founding Engineers, startup veterans, or core product engineers with proven 0-to-1 build capability.
Target Domains: Candidates from FinTech, Healthcare / Insurance, or B2B SaaS Product Startups.
(Note: We are strictly looking for product/startup backgrounds; candidates from service-based or consulting backgrounds will not be considered).
Tech Stack:
Backend Core: Node.js, NestJS, Express, TypeScript, Apollo GraphQL.
Data Layer and Storage: PostgreSQL (Prisma 7 ORM), Read Replicas, Redis.
Frontend Client: Vue 3 / Vuex, React.js .
Cloud and DevOps: Google Cloud Platform (GCP - Pub/Sub, App Engine Cron, Cloud Functions), Docker, GitHub Actions CI/CD.
Integrations: Stripe, NMI, SendGrid, Twilio, Dosespot, Calendly, HubSpot.

Experience
5-9 yrs