Description MEDvidi is an AI-powered mental healthcare clinic setting a new standard for safe, effective, and scalable psychiatric care in the United States. We combine licensed providers with proprietary AI tools to deliver consistent, outcomes-driven treatment for conditions like ADHD, anxiety, depression, and more. MEDvidi's technology automates charting, follow-ups, and treatment planning, freeing providers to focus on patient care while improving efficiency and clinical quality. We're looking for a Senior Backend (NodeJS) Engineer to join our AI Automation team and lead the development of AI-driven integrations within our telemedicine platform. You will design and scale the backend systems that connect our core product with AI services, directly improving how thousands of patients and providers interact with MEDvidi every day. You'll work at the intersection of backend engineering and applied AI, building production-grade systems that automate clinical and operational workflows. You'll collaborate closely with AI engineers, product teams, and cross-functional stakeholders to ship reliable, scalable automation, from multi-agent orchestration to RAG pipelines. Responsibilities • Design and build backend architecture for AI-powered automation systems, with a focus on performance, scalability, and resilience. • Integrate and scale LLM-based product features in close collaboration with AI engineers and product teams. • Implement and evolve agent-based systems (e.g., ReAct, supervisor-agent models) supporting complex decision-making flows. • Optimize Retrieval-Augmented Generation (RAG) pipelines and context enrichment using structured and unstructured data. • Develop robust APIs for internal services and external integrations. • Ensure strong observability, monitoring, and alerting practices using tools like Grafana and OpenSearch. • Participate in code reviews, contribute to architecture discussions, and maintain high-quality technical documentation for newly designed systems and APIs. Requirements • 8+ years of commercial backend development with Node.js in product companies (preferably SaaS), with deep understanding of complex backend systems end-to-end. • Strong experience designing backend architectures and technical solutions, including system decomposition, scalability trade-offs, long-term maintainability, and technology choices. • Proven track record building scalable, high-performance backend systems and robust APIs, with solid understanding of data flows, failure modes, and performance bottlenecks. • Hands-on experience integrating LLMs into production systems (not demos), with focus on reliability, predictability, cost control, and measurable quality improvements. • Experience designing and implementing multi-agent AI workflows in production, including orchestration logic, ReAct patterns, supervisor-agent architectures, and clear understanding of when such approaches are justified. • Practical experience with modern AI frameworks • Solid experience designing and optimizing RAG pipelines: embeddings, vector databases, retrieval strategies, ranking, chunking, and quality vs. latency trade-offs. • Strong prompt engineering skills, including structured outputs (JSON/YAML), schema validation, evaluation-based iteration (e.g., AI eval frameworks), and reliability techniques beyond prompt-only solutions. • Understanding of LLM infrastructure in production environments: tracing and observability (LangSmith, Langfuse, or similar), evaluation frameworks and quality metrics, tooling and orchestration, safety mechanisms and guardrails, performance and cost optimization. • Hands-on experience with PostgreSQL (schema design, migrations, performance optimization) and AWS (CDK, Lambda, API Gateway, ElastiCache). • Good understanding of observability and debugging (Grafana, OpenSearch, or similar). • Strong engineering culture: testing, CI/CD, reliability, and technical ownership. • Product-oriented mindset with the ability to build user-centered automation, not isolated technical components. • Proactive AI enthusiast mindset: explores and validates new AI approaches and patterns applicable to product use cases. • Fluent Russian; English B2+. Would be a plus • Experience working with medical/healthcare AI or regulated environments. • Experience with MCP (Model Context Protocol) in Node.js. What we offer • High-impact environment: A chance to contribute to a product-driven company in the medical tech space. • Growth & compensation: Clear growth opportunities and a competitive compensation package. • Remote-first: Fully remote long-term collaboration under a B2B model. • Health & wellness: Health insurance after the probation period, plus sports and wellness compensation. • Career development: Personalized English lessons via Preply and clear growth paths. • Time off: 19 paid vacation days annually, 4 additional wellness days each year, and paid sick leave for the first 5 working days. • Culture: Thoughtful gifts for key life events and offline corporate events. Ready to make an impact? Send us your profile, let's build something meaningful together.  MEDvidi is an Equal Opportunity Employer. We celebrate diversity and are committed to creating an inclusive environment for all employees and contractors. All qualified applicants will receive consideration without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status. Originally posted on Himalayas