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 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 If you’ve ever used outdated legacy medical software and thought “there must be a better way,” this is the team making it happen.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