Senior Backend Engineer – Global Healthtech (.NET / C#)

About this role

Senior Backend Engineer – Healthtech (.NET / C#)
Remote (South Africa) | Full-Time | Salary Package: R100,000 – R115,000 per monthIncludes: base salary, employer retirement contribution, monthly medical aid contribution
About the Company
Our client is a European healthtech startup building modern practice management software for healthcare professionals. They are building modern, intuitive practice management software that reduces administrative burden for medical professionals and enables deeper system-wide healthcare integration.
If you’ve ever used outdated legacy medical software and thought “there must be a better way,” this is the team making it happen. Their mission: enable better healthcare experiences through thoughtful technology. They operate with strong values of ownership, excellence, integrity, and collaboration, and their lean, product-driven team focuses on building software used by healthcare professionals
The Role
We are looking for a Senior Backend Engineer (.NET / C#) to take a high-ownership role within a cross-functional product team.
You will build the core services layer of a sophisticated cross-platform application, designing secure, scalable, and maintainable backend systems that directly support healthcare delivery. This role goes beyond coding, it requires architectural input, mentoring teammates, and shaping the long-term technical direction of the platform.
What You’ll Be Responsible For

• Designing and building APIs for frontend applications and external integrations

• Managing complex, structured, and sensitive healthcare data

• Contributing to architectural decisions grounded in Domain-Driven Design (DDD) and SOLID principles

• Collaborating daily with Product Owners, UX/UI Designers, QA, and DevOps

• Refining requirements, planning user stories, and estimating delivery

• Conducting code reviews and mentoring team members

• Continuously improving code quality, architecture, and engineering processes

Requirements
Required Experience and Skills

• 8+ years of backend engineering experience

• Expert-level proficiency in C# and .NET Core

• Strong experience with ASP.NET and Entity Framework Core

• Solid experience with relational databases (PostgreSQL preferred)

• Strong Git experience in collaborative environments (branching, merge requests, conflict resolution)

• Experience in cross-functional Agile (Scrum) teams

• Comfortable with pair programming and code reviews

• Strong written and verbal English communication skills

Nice to Have

• Experience in regulated industries (healthcare strongly preferred)

• Familiarity with DDD and CQRS

• API-first and RESTful design experience

• Automated testing experience (TDD/BDD)

• Knowledge of FHIR and HL7 standards

• Strong PostgreSQL expertise

• GitLab CI/CD experience

• Docker experience

• General understanding of frontend fundamentals

Who This Role Is For

• Self-starters who can operate independently and own mission-critical systems

• Engineers who thrive in lean, high-accountability environments

• Individuals who care deeply about code quality and product impact

Tech Stack
C#, .NET Core, ASP.NET, EF Core, PostgreSQL, Git, GitLab, Docker, Visual Studio / Rider
About Project Y
This role is recruited by Project Y, a recruitment agency connecting South African tech talent with global opportunities. Applications will be managed through Project Y.
Highlights
Senior Backend Engineer (.NET/C#) | Remote South Africa | R100k–R115k | Build high-impact healthcare software in a fast-growing, mission-driven startup.
Originally posted on Himalayas