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If you’ve ever used outdated legacy medical software and thought “there must be a better way,” this is the team making it happen.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 .
Highlights
Senior Backend Engineer (.NET/C#) | Remote South Africa | R100k–R115k | Build high-impact healthcare software in a fast-growing, mission-driven startup.
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