Staff Software Engineer, Distributed Systems

San Francisco, United StatesHybrid

Responsibilities

Design multi-tenant data patterns that maintain performance while balancing isolation tradeoffs. - Caching & Latency Optimization — Build caching infrastructure that keeps EHR API latency out of critical user paths.
Identify and optimize hot paths across the application.
Build instrumentation to catch performance regressions before they reach users. - Rate Limiting — Design systems that respect EHR API rate limits while maintaining user experience.
Build infrastructure that degrades gracefully under load: queue management, circuit breakers, load shedding. - Reliability & Observability — Dashboards and alerting for database performance, cache hit rates, connection pool utilization, API latency by customer.

We’re building the AI intelligence platform that restores humanity to healthcare and drives meaningful ROI for health systems across the country.
Experience in the KLAS Research Emerging Solutions Top 20 Report, recognized by Fast Company as one of the Next Big Things in Tech, named one of the best AI companies in healthcare by Inc., and selected as a LinkedIn Top Startup in 2024 and 2025.
Who You Are: - 7+ years in software engineering, 3+ focused on infrastructure, backend systems, or platform engineering - Staff-level scope: owned cross-cutting infrastructure, debugged production issues that stumped others - Strong backend fundamentals in Python, Go, TypeScript, or similar - Deep

benefits include - Comprehensive medical, dental, and vision coverage for you and your dependents - 401(k) with a company match of up to 3% of base salary - A remote-friendly culture (with a San Francisco HQ) and full equipment provisioning to ensure you can work effectively from wherever you’re based.
- Parental leave to support your family needs - Annual company-wide off-sites, team off-sites and regular team lunches and all-hands gatherings, with travel, lodging and meals covered - Flexible time off with no annual cap, company-wide holidays and an annual holiday shutdown from December 24–January 1 designed to support real rest and long-term sustainability.
Ambience Healthcare is an equal opportunity employer and is committed to building a diverse and inclusive workplace.

If you need any accommodations during your application or interviews, please reach out to our Recruiting team at accommodations@ambiencehealthcare.com recruiting@ambiencehealth.com.
Our emails will always come from @ambiencehealthcare.com.
Report the issue immediately to LinkedIn and the FBI https://www.fbi.gov/how-we-can-help-you/scams-and-safety.

About Us: Here at Ambience, we never set out to be just another scribe.
Our technology helps providers focus on delivering great care by removing the administrative burden that pulls them away from patients and away from their most impactful work.
Ambience delivers real-time coding-aware documentation and clinical workflow support across ambulatory, emergency and inpatient settings at the top health systems in North America.
Our teams operate relentlessly with extreme ownership to build the best solutions for our health system partners.
We value candor, positivity and deep thought — and we expect a lot from each other because we know the problems we’re solving truly matter.
Ambience was ranked #1 for Improving the Clinician
We’re backed by Oak HC/FT, Andreessen Horowitz (a16z), OpenAI Startup Fund, and Kleiner Perkins — and we’re just getting started.
The Role: Ambience processes millions of patient encounters across the nation's largest health systems.
These organizations trust us with real-time clinical workflows where latency and reliability directly impact patient care.
A slow response during a patient visit isn't just a bad metric; it's a physician abandoning the tool.