Engineering Manager, Backend Team

• Hands-On Engineering: Spend the majority of your time designing, writing, and reviewing backend code across our services and APIs, and set the standard for quality through your own work.
• Team Leadership and Development: Manage and grow a team of backend engineers through regular feedback, coaching, and clear expectations for what great work looks like.
• Hiring: Lead hiring for our backend and devops opportunities.
• Backend Architecture: Own architecture decisions for high-volume backend systems, including service design, data modeling, API and SDK design, and performance, so the platform scales reliably with our customers.
• Infrastructure and DevOps: Own our AWS infrastructure, CI/CD pipelines, and deployment automation, and drive DevOps maturity as the team grows.
• Reliability and Observability: Own production health for backend systems, including monitoring, alerting, on-call, incident response, and postmortems that lead to real fixes.
• Security and Compliance: Make sure backend systems and infrastructure meet healthcare data security standards, including HIPAA and SOC 2, from design through deployment.
• Project and Timeline Management: Scope, sequence, and track delivery across concurrent backend work streams, keep stakeholders informed, and keep commitments realistic.
• Cross-Functional Partnership: Work closely with product, front-end engineering, and our interoperability team to turn requirements into well-scoped technical plans and keep shared systems running smoothly.
• Engineering Standards: Raise the bar on testing, code review, and development process so the team ships quickly without sacrificing reliability.

• 10+ years of software engineering experience, including 2+ years managing a team of 4-8 engineers while staying hands-on in the code
• Deep backend expertise in Python/Django and/or Node.js + TypeScript, including relational database design and performance tuning in PostgreSQL or similar
• Production ownership: you’ve been accountable for systems in production, including on-call, incident response, observability, and postmortems
• A history of technical leadership: driving architecture decisions, setting engineering standards, and building consensus on hard technical tradeoffs
• Working knowledge of AWS, CI/CD, and infrastructure-as-code, enough to own infrastructure decisions directly
• Proven ability to hire, develop, and retain strong engineers
• Experience at an early or growth stage startup: comfortable building structure where none exists and making judgment calls without a playbook

• Experience building systems that handle HIPAA-protected data or operate in another compliance-heavy industry (SOC 2, fintech, etc.)
• Hands-on experience with Terraform, Docker/Kubernetes, and Datadog or similar observability tooling
• Background in scheduling, logistics, or optimization systems
• Experience building data pipelines or ETL into cloud data warehouses for analytics and reporting
• Experience using AI tools like Claude Code or Cursor to speed up development and review workflows

Axle Health builds AI-powered scheduling and workforce management software for home health organizations. The backend is what everything else depends on: the services and APIs behind every schedule, the infrastructure they run on, and the reliability our customers’ clinicians count on every day. We’re hiring a backend Engineering Manager to lead our backend team of six engineers. You’ll report to our CTO and own the technical direction, delivery, and production health of our backend systems and cloud infrastructure.

This role is roughly 60% hands-on and 40% management. You’ll write, review, and ship code alongside your team while coaching engineers, running delivery across concurrent work streams, and making key hires in your first few months. The person who thrives here wants to stay close to the code and sees that as part of how they lead. You hold a high bar for reliability and code quality, and you’re comfortable making architectural calls quickly in a fast-moving startup environment.

You’ve done this before. You’ve led a backend team of similar size while staying hands-on, owned systems in production through incidents and on-call, and been the person engineers look to for technical direction. You know how to balance shipping quickly with building systems that hold up as customer volume grows.

We do not monitor YC applications, please apply directly on our website to be considered for this position: https://www.axlehealth.com/careers

• Django + Python 3
• Node.js / ExpressJS + TypeScript
• GraphQL
• PostgreSQL
• AWS
• Terraform, Docker / Kubernetes
• Datadog
• Git / GitHub / Graphite
• Claude Code and Cursor

In addition to offering a competitive salary and equity, we want to ensure every team member has the tools they need to work to the best of their ability. To that end…

We are committed to your Ownership

• We cultivate an environment where team members feel ownership over the work they do. Everyone in an organization has big ideas and we want to hear them and implement them.
• All of our employees have equity compensation. We want you to benefit from all the hard work you do in helping patients and catalyzing this shift in healthcare.

We are committed to your Wellness

• Medical, Dental, Vision
• 401k plan
• Flexible PTO and sick days
• Commuter benefits
• Santa Monica HQ with 180 degree beach views and daily catered lunches

We are committed to your Growth

• Fast paced work environment geared towards professional growth
• Get the chance to move roles within the organization to learn new skills and continue to make an impact

We are committed to building Community

• Monthly team events, dinners, & happy hours
• Special team outings - some past events have included: yacht cruises, visits to Universal Studios, Magic Castle, and Vegas

Axle Health builds AI scheduling and workforce management software to empower in-home healthcare providers to deliver exceptional, personalized care right where patients feel most comfortable—at home.

Some of the biggest providers in the country use our software (like Cityblock Health and U Penn Health System) to improve the utilization of their field teams by 17%+, and automate the operational burden of scheduling and dispatching.

Our platform includes proprietary logistics algorithms to optimize scheduling, a mobile app for field staff, an operations dashboard for office teams, engagement and booking tools for patients, and a wide range of integrations and external APIs for modular access.

We’re a team of top-tier engineers and operators, backed by $14m from top investors such as Y Combinator, Pear VC, and F-Prime, applying our intellect and logistics experience to upend how home healthcare is delivered.