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

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 contributionAbout the CompanyOur 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burden for medical professionals and enables deeper system-wide healthcare integration.If you’ve ever used outdated legacy medical software and thought “there must be a better way,” this is the team making it happen.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 professionalsThe RoleWe 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 ForDesigning and building APIs for frontend applications and external integrationsManaging complex, structured, and sensitive healthcare dataContributing to architectural decisions grounded in Domain-Driven Design (DDD) and SOLID principlesCollaborating daily with Product Owners, UX/UI Designers, QA, and DevOpsRefining requirements, planning user stories, and estimating deliveryConducting code reviews and mentoring team membersContinuously improving code quality, architecture, and engineering processesRequirementsRequired Experience and Skills8+ years of backend engineering experienceExpert-level proficiency in C# and .NET CoreStrong experience with ASP.NET and Entity Framework CoreSolid experience with relational databases (PostgreSQL preferred)Strong Git experience in collaborative environments (branching, merge requests, conflict resolution)Experience in cross-functional Agile (Scrum) teamsComfortable with pair programming and code reviewsStrong written and verbal English communication skillsNice to HaveExperience in regulated industries (healthcare strongly preferred)Familiarity with DDD and CQRSAPI-first and RESTful design experienceAutomated testing experience (TDD/BDD)Knowledge of FHIR and HL7 standardsStrong PostgreSQL expertiseGitLab CI/CD experienceDocker experienceGeneral understanding of frontend fundamentalsWho This Role Is ForSelf-starters who can operate independently and own mission-critical systemsEngineers who thrive in lean, high-accountability environmentsIndividuals who care deeply about code quality and product impactTech StackC#, .NET Core, ASP.NET, EF Core, PostgreSQL, Git, GitLab, Docker, Visual Studio / RiderAbout Project YThis role is recruited by Project Y, a recruitment agency connecting South African tech talent with global opportunities. Applications will be managed through Project Y.HighlightsSenior 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