Lead .NET Backend Engineer

As a Lead Backend .NET Developer at iScribeHealth, you will play a key role in developing and maintaining the core infrastructure that powers our real-time AI documentation and medical billing platform.
Technology (Core Technology Team)
Full-Time
3+ years

iScribeHealth is an AI-powered virtual scribe solution that helps healthcare providers efficiently document patient care and sync data with Electronic Health Records (EHR) systems. Founded in 2015, we are dedicated to reducing provider burnout and improving healthcare efficiency through cutting-edge AI and automation. Our platform streamlines workflows, enabling doctors to focus on patient care while ensuring seamless EHR integration. At iScribeHealth, we empower our employees to make a meaningful impact—both for themselves and the patients we serve.

As a Lead Backend .NET Developer at iScribeHealth, you will play a key role in developing and maintaining the core infrastructure that powers our real-time AI documentation and medical billing platform. You’ll work in a fast-paced, collaborative environment where your contributions will directly impact clinicians and patients. A high-impact, fast-paced individual who is a versatile, self-driven engineer who thrives in uncertainty and moves quickly from idea to execution to help us scale and innovate faster.

Essential Duties and Responsibilities:

• Design, develop, and maintain scalable .NET APIs and backend services supporting real-time AI scribe functionality and medical billing workflows.

• Architect and manage core infrastructure components, including database and endpoint architecture, with a focus on performance, reliability, and failover readiness.

• Ensure high system availability and uptime by proactively addressing performance-critical areas—no Sev1 or Sev2 incidents tolerated.

• Collaborate closely with machine learning engineers, frontend developers, and product managers to deliver features that directly improve user experiences.

• Lead secure and reliable integration with external Electronic Health Record (EHR) systems (e.g., athena, Epic), billing platforms, and third-party APIs.

• Implement and enforce data security and compliance strategies across all internal and public-facing infrastructure components.

• Manage and evolve the iScribe user authentication pipeline to maintain secure access and seamless user experiences.

• Oversee deployment and maintenance processes for all backend infrastructure and integration endpoints, ensuring timely updates and effective version control.

• Build and maintain infrastructure reporting tools, dashboards, system status pages, log aggregation, and alerting mechanisms to support proactive monitoring.

• Champion clean coding practices, automated testing, CI/CD pipelines, and DevOps best practices aligned with healthcare-grade quality standards.

• Maintain clear and up-to-date documentation of backend systems, including internal wikis, integration specifications, and operational runbooks.

• Contribute to the strategic roadmap for backend scalability as the platform expands to support diverse care settings and geographies.

Qualifications:

• 3+ years experience in backend development, with deep expertise in .NET Core and C#.

• Strong understanding of REST APIs, asynchronous processing, SQL/NoSQL databases, and distributed systems.

• Experience with Azure cloud services (App Services, Functions, Cosmos DB, Traffic Manager, Front Door, etc.).

• Passion for building resilient, secure, and observable systems in a regulated environment (HIPAA, PHI).

• Experience integrating with or building around EHR systems, FHIR APIs, or medical billing tools is a strong plus.

• Ability to mentor junior engineers, do thorough code reviews, and drive architectural decisions.

Preferred Skills:

• Prior entrepreneurship experience

• Prior experience in health tech, EHR integrations, AI, or machine learning.

• Exposure to serverless computing, edge AI, or emerging cloud-native architectures.

• Familiarity with low-code/no-code solutions, automation, and developer tools.

Must align with iScribeHealth’s Core Values: Cares Deeply, Resourceful, Accountable, Customer-obsessed and Knowledgeable

Next Steps:

At iScribeHealth, we assign specific attributes and characteristics to each role. This helps us identify candidates whose natural strengths align with the demands of the position—contributing to both job satisfaction and long-term success. Our goal is to ensure that employees feel confident and fulfilled in their roles, rather than feeling like they have to stretch themselves unnaturally every day to meet expectations.

The survey includes only two questions and typically takes less than 10 minutes to complete. For the second question, “Describe How You Should Behave at Work,” please answer based on your behavior in your current or most recent role—not the role you’re applying for.You can access the survey using the following link: iScribeHealth.

Once the survey is completed email resume to recruiting@iscribehealth.com

Why Join Us?

• Opportunity to impact the future of healthcare technology and AI-driven solutions.

• Competitive salary and benefits including Medical, Dental, Vision, HSA/FSA, HSA Dependent Care, Pet Insurance, and 401k.

• Collaborative, dynamic team environment focused on innovation and growth. iScribeHealth is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability status, protected veteran status, or any other characteristic protected by law.

Medicine is about care not clicks.

Doctors save up to 2 hours a day with iScribeAI while focusing more on patient care and reducing burnout.

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