Senior Backend Engineer – Healthtech (.NET / C#)
Remote (South Africa) | Full-Time | Salary Package: R100,000 – R115,000 per month Includes: 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If you’ve ever used outdated legacy medical software and thought “there must be a better way,” this is the team making it happen.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
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Designing and building APIs for frontend applications and external integrations
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Managing complex, structured, and sensitive healthcare data
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Contributing to architectural decisions grounded in Domain-Driven Design (DDD) and SOLID principles
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Collaborating daily with Product Owners, UX/UI Designers, QA, and DevOps
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Refining requirements, planning user stories, and estimating delivery
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Conducting code reviews and mentoring team members
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Continuously improving code quality, architecture, and engineering processes
Required Experience and Skills
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8+ years of backend engineering experience
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Expert-level proficiency in C# and .NET Core
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Strong experience with ASP.NET and Entity Framework Core
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Solid experience with relational databases (PostgreSQL preferred)
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Strong Git experience in collaborative environments (branching, merge requests, conflict resolution)
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Experience in cross-functional Agile (Scrum) teams
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Comfortable with pair programming and code reviews
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Strong written and verbal English communication skills
Nice to Have
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Experience in regulated industries (healthcare strongly preferred)
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Familiarity with DDD and CQRS
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API-first and RESTful design experience
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Automated testing experience (TDD/BDD)
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Knowledge of FHIR and HL7 standards
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Strong PostgreSQL expertise
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GitLab CI/CD experience
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Docker experience
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General understanding of frontend fundamentals
Who This Role Is For
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Self-starters who can operate independently and own mission-critical systems
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Engineers who thrive in lean, high-accountability environments
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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.
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