Job Description
Trial Library is an AI-native research platform with a mission to improve healthcare outcomes by expanding access to precision medicine.
About Trial Library
Trial Library is an AI-native enrollment and care navigation platform that accelerates access to precision medicine. In collaboration with biopharmaceutical manufacturers, payers, and health systems, Trial Library enables the delivery of clinical trials as a standard care option - improving patient access, advancing oncology outcomes, and reducing the total cost of care. Backed by leading healthcare venture capital firms, Trial Library’s platform is currently deployed in 840+ clinics and 3,000+ providers nationwide.
About the Role
We’re hiring a second Staff Engineer to own key parts of our backend and data platform. Our platform supports our teams that identify eligible patients for clinical trials and navigate patients around any barriers to enrolling in a trial. You will take technical leadership of our most critical systems as we navigate a massive architectural shift that will be a step-change in our ability to refer patients to trials: moving from narrow, human-assisted data pulls to robust, automated integrations with EMR systems to ingest complete patient records. If cloud-native architecture, building AI agents to empower our human experts, exploring non-deterministic approaches to patient-trial matching, and handling HIPAA-grade data sounds like the right problem space, please keep reading. Our engineering culture values direct communication, strong ownership, and low-ego collaboration. We laugh a lot and use a ton of Slack emojis. We make decisions quickly, give open feedback, and we have a strong bias toward action.
How We Build with AI
Our use of AI in our products is intended to make our authentic interactions with patients, doctors, and others as meaningful as possible. That means using AI to help with all of the operational aspects of the interactions, from helping decide who to call and when, to assisting with transportation scheduling, to queuing up ranked potentially eligible patients for a human to review and validate. This enables our people to focus 100% on authentic interactions with other people.
AI is also deeply embedded in our SDLC. Our embrace of AI didn’t come from a mandate but from our own desire as engineers to do more safely. We use it for coding, testing, measuring, and iterating. We’ve seen what it unlocks and treat it as a genuine competitive advantage. We view effective use of these tools as an important part of engineering leverage and velocity.
We are looking for someone who shares that instinct: someone excited to reinvent long-standing processes, question assumptions about where human attention should be focused, and think ambitiously about what is possible when you pair strong engineering fundamentals with AI tooling. If you are already building that way, you will fit right in.
Underneath all of this is a modern, evolving platform built for scale and iteration. Our backend is primarily Python and actively moving toward Typescript. Our frontend is a React (Typescript) SPA, and our infrastructure is built on AWS using Lambda, Bedrock, Fargate, SQS, and RDS with Terraform-managed infrastructure. Our data layer is centered around PostgreSQL and Drizzle. We care deeply about pragmatic architecture decisions, developer velocity, and building systems that can evolve quickly as both our product and AI capabilities mature.
Your Responsibilities
You will own the systems that power Trial Library’s core workflows and be accountable for their reliability, evolution, and scale.
A meaningful part of that is designing for reliability in compute-intensive, long-running workflows: the kind of problems where serial processing breaks under load, timeouts become production incidents, and the right architecture (async pipelines, message queues, container-based compute) is what separates a working feature from a failing one. You will independently monitor production, triage issues quickly, and maintain a close read on how our platform is actually experienced by the clinicians, coordinators, and partners who depend on it. You’ll exercise pragmatic judgement, matching the technology to the business need. As we grow this will more and more include decisions around which AI models to use, and how to operationalize “token economics”.
Beyond technical ownership, you will shape how good engineering gets done at Trial Library. As AI coding tools and improved models change what’s possible and how the whole team works, this role calls for someone who will continuously rethink what engineering excellence actually looks like. You are excited to transition the team into a world less bottlenecked by execution, and more by review and verification.
You keep a close pulse on how AI is changing software development, evaluate emerging practices critically, and champion the approaches that make sense for our organization .These best practices may include standards for how code reviews are done, how tests get written, what shared conventions need to exist, and where human judgment is most needed. You’ll mentor engineers and set development standards that stay relevant as the tools underneath all of us keep evolving.
Your Qualifications
We are looking for an engineer with significant backend depth, 8 or more years of experience, with at least a couple of years operating at staff scope or equivalent impact. Beyond tenure, what matters most is whether you have demonstrated the kind of high-impact ownership this role requires.
Deep AWS experience (Lambda, Fargate, SQS, RDS, and the surrounding ecosystem) and the ability to choose the right service for the right job
Proven track record of leveraging AI coding tools creatively and effectively to build production systems.
Demonstrated ability to take autonomous ownership, identifying and resolving systemic issues independently.
Startup experience, where you have built from scratch at an early-stage company and treated ambiguity as an opportunity rather than an obstacle
Strong systems thinking, encompassing backend architecture, APIs, databases, and scalability under real-world constraints.
Clear communication and influence, with the ability to explain tradeoffs to both engineers and non-engineers to earn trust through honesty
Healthcare alignment with a genuine interest in improving clinical trial access and health equity; HIPAA experience a strong plus
Nice to Have
Experience with data and analytics platforms, such as data warehouses, ETL pipelines, or external-facing reporting infrastructure, is particularly relevant. Familiarity with IaC tooling (Terraform, Pulumi, etc), clinical or healthcare data standards (EHR/EMR, HL7/FHIR), and API design patterns are all additive. Experience in a regulated industry is a plus.
$168,000 - $230,000 a year
Compensation & On-Site Requirement
This is a hybrid role based in San Francisco, CA, with a requirement of three days per week in the office; Wednesday, Thursday, and Friday. The salary range for this position is $168,000–$230,000 per year and reflects a good faith estimate of base pay for candidates working in this location. Final compensation will be based on experience, skills, and qualifications.
Why Trial Library
- Meaningful impact — helping patients access clinical trials faster through better technology and workflows
- High ownership environment — autonomy to build, test, and influence strategy across the business
- Collaborative team culture — low ego, high trust, and close partnership across functions
- Opportunity for growth — join at an early stage with meaningful exposure to company-building and decision-making
Our Core Values
- Ally is our favorite moniker
- The broadest reach is worth the effort
- Celebrate measurable improvements in access and outcomes
- Fearless advocates for representation in research
- Incentives matter to stakeholders choosing our products
- Taking initiative is actually giving
- We are accountable for the experience of patients and providers
- Empathy and humility are the real dynamic duo
Our Benefits & Perks
- Health & Wellness: Comprehensive medical, dental, and vision coverage for employees and eligible dependents, along with disability, life, and supplemental insurance options designed to support your overall well-being.
- Time Off & Workplace Support: Flexible paid time off, observed company holidays, and a one-time home office stipend to help you create a productive and comfortable remote workspace within our hybrid environment.
- Financial & Lifestyle Benefits:401(k) program, pre-tax HSA and FSA options, commuter benefits, financial wellness resources, and access to legal protection plans to support both short- and long-term planning.
- Additional Support & Voluntary Benefits: Access to voluntary benefit offerings including pet wellness support, domestic partner coverage, and additional programs that support the diverse needs of our team members and their families.
Our Interview Process
Our interview process typically includes four stages, followed by reference checks and an offer. Depending on the role, particularly for technical or senior positions, the process may vary slightly and can include a technical assessment, case study, presentation, practical exercise, additional interview conversations, or conversations with members of our leadership team and investors.
Trial Library, Inc. is an equal opportunity employer committed to building an inclusive workplace. We provide equal employment opportunities to all employees and applicants and prohibit discrimination and harassment of any kind without regard to race, color, religion, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity or expression, national origin, ancestry, age, disability, genetic information, marital status, veteran status, military status, medical condition, family or medical leave status, political affiliation, or any other characteristic protected by applicable federal, state, or local law.
Trial Library, Inc. is committed to providing reasonable accommodations for qualified individuals with disabilities throughout the recruiting process. If you require assistance or accommodation, please contact [email protected]
We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.
