Senior Back End Engineer (Agentic Systems Engineer)

Location: Stellenbosch - Cape Town (Hybrid)

Reports To: Head of Engineering / CTO

Pinotage Health Corporation is building a US healthcare agentic workflow platform that transforms doctor and patient encounters. Our mission is to reduce the administrative burden on physicians through agentic AI systems that are safe, reliable, and clinically correct - so doctors can spend more time with patients, not paperwork.

Our solutions dramatically shorten administrative cycles, improve medical coding accuracy, and reduce operational friction using advanced LLM powered orchestration systems. This means that doctors can focus on patient care, patients experience improvement with doctors that are present, and overall healthcare delivery costs are reduced.

The US health system is one of the most complex, fragmented systems on the planet. US doctors have become so overburdened with compliance and administrative work, that fewer students opt to become doctors and more doctors leave the profession earlier than expected. Meanwhile, the US population is aging and living longer. With fewer doctors serving an enlarging demand, healthcare costs and delivery pressure has gotten to a point where the ecosystem is actively seeking innovative, new ways of doing things - it's a market begging for disruption. Pinotage is positioned perfectly in the eye of that storm.

Our mission is to bring humanity back to healthcare, with our proprietary agentic solutions.

We are a global team with roots in South Africa as our name suggests, and we are building a team of A players to tackle the problems and opportunities in large, complex markets.

Own the clinical intelligence layer of the platform. You'll architect, build and evaluate LLM agentic systems for medical coding and documentation, curate datasets, and run SME feedback loops with clinicians - while also engineering the backend that operationalizes these agents in production.

• Design and evaluate LLM agents for medical coding (CPT, ICD 10, NCCI, MDM) and clinical documentation.
• Curate and maintain coding datasets (AMA, CMS) for training and evaluation.
• Write and refine prompt templates, enforce structured outputs.
• Build evaluation rubrics, regression detection workflows, and monitoring pipelines.
• Implement human in the loop workflows for quality assurance.
• Develop backend services (Python, FastAPI, async runtimes) to operationalize AI agents. (ML Ops)
• Cross disciplinary engagement/work with other teams (DevOps, Product, Frontend & Backend)

• Contribute to frontend integrations / teams
• Deploy AI services via Docker/Kubernetes on GCP, ensuring observability and compliance. Where needed.

• 3-5 years of software development/engineering experience
• PhD or equivalent advanced research background in AI, NLP, or related fields.
• Strong track record in prompt engineering and LLM evaluation.
• Clinical informatics or medical coding domain knowledge.
• Strong Python background & experience Ruby experience is a plus
• Experience with observability frameworks
• Proven ability to design evaluation rubrics and benchmarking frameworks.
• Docker/Kubernetes deployment experience, GCP cloud services.

• RAG architectures and embedding retrieval systems.
• Healthcare regulatory familiarity (HIPAA, SOC2).
• Vertex AI / Gemini exposure.
• Prior work formalizing AI workflows into defensible IP frameworks.

• Honours degree in Computer Science, Engineering, or a related field; or equivalent professional experience.
• PhD strongly preferred in AI/ML, NLP, or related domains.
• GCP ML Certification or equivalent is advantageous.

Pinotage Health is an AI powered healthcare platform that automates clinical documentation, coding, billing, and compliance for doctors and healthcare orgs.

Our mission is to reduce administrative burden on clinicians using AI.