Software Engineer, Voice Platform

About Sage Care

Sage Care is a fast-growing, early-stage healthcare startup founded by exceptional leaders from Apple, Uber, Carbon Health and backed by top-tier venture capital (General Catalyst, Chelsea Clinton). With a strong customer pipeline, Sage Care is transforming healthcare by simplifying care navigation.

Our platform makes it easier for patients to find the right doctor, helps providers focus on those who need them most, and ensures faster access to care, delivering better care and stronger economic outcomes at scale through harnessing the latest AI innovations.

Building on our successful collaborations with health systems across the U.S., we have expanded internationally to the MENA region. We are now partnering with health systems there to deploy our AI-powered care navigation platform.

About the Role

We’re hiring an experienced backend engineer to build the real-time platform behind our AI voice agents. You’ll build systems that keep live calls responsive and reliable, and make it easier for engineers to develop new patient workflows and adapt them for different healthcare partners.

The work spans session state, workflow execution, integrations, concurrency, and failure recovery. Prior Rust or AI experience is welcome but not required.

What You'll Do

• Design and evolve the architecture of our real-time voice platform as we scale across healthcare partners and more complex workflows.
• Build the runtime and abstractions for session state, workflow execution, and model orchestration so product engineers can develop new flows.
• Make architectural tradeoffs across latency, concurrency, reliability, and cost, grounded in production behavior and load testing.
• Drive the migration to Rust, including service boundaries, runtime design, and rollout in production.
• Diagnose systemic performance and reliability problems, and address their root causes across our services and external dependencies.
• Set AI native engineering standards for platform changes, including design reviews, testing, observability, and production readiness.

What We're Looking For

Required

• 5+ years of professional software engineering experience, with substantial experience building and operating real-time production backend systems.
• Strong experience designing, building, and operating high-load, latency-sensitive backend systems.
• A track record of leading substantial technical projects, making architecture decisions, and delivering them through production rollout.
• Deep understanding of concurrency, asynchronous execution, networking, and distributed systems failure modes.
• Experience diagnosing performance bottlenecks and reliability issues using production evidence.
• Ability to design abstractions and service boundaries that make other engineers more effective.
• Strong coding skills and sound judgment about when to build for scale and when to keep things simple.

Nice to Have

• Rust experience, particularly in production systems.
• Experience with voice, audio, streaming, or telephony infrastructure.
• Experience building agent runtimes, model orchestration, or LLM serving systems.
• Experience evolving a platform while supporting live production traffic.