Senior Software Engineer Backend at Cera in GB

About Cera

Cera is the UK’s largest HealthTech company and one of Europe’s fastest-growing businesses – harnessing preventative technology and AI to take care out of Britain’s hospitals and into patients’ homes. Our 10,000 carers and nurses deliver around 2.5 million patient home visits a month – a volume greater than all A&E attendances across England.

Cera is now Europe’s largest HealthTech company and one of its fastest-growing businesses, with circa $500 million in annualised revenues and 150-fold growth in impact over the past five years. Cera has also gathered the largest home healthcare dataset in Europe, powering the development of cutting-edge AI products that have reduced hospitalisations by up to 70%, saving the UK Government and NHS more than £1 billion to date.

The UK’s Number 1 ranked HealthTech company, Cera’s pioneering approach has been recognised by numerous industry awards, including a Newsweek AI Impact Award, the UK Tech Awards’ Tech for Good Prize, Health Tech Digital’s Best Use of Artificial Intelligence, the Deloitte Fast 50 and EY’s prestigious UK Entrepreneur of the Year Award 2024. Cera was recently recognised by TIME Magazine as one of the World’s Top HealthTech Companies and as the Number 1 Healthcare AI Company for 2025.

About the role

You’ll build and ship production software in a cross-functional team. You don't just take specs; you grasp the why behind a feature and push for a smarter, faster way to deliver it.

Because AI agents write most of our code, your technical bar needs to be high. You can’t spot a subtle bug in code you didn't write unless you know how to build it from scratch, from underlying data structures and algorithms to transaction boundaries, service architecture, and failure points. What ships to production hinges on your review of its security, performance, and correctness.

Expect to rotate through different domains roughly every six months. This gives you enough runway to build real domain expertise while staying close to the business. You’ll tackle high-value engineering challenges like our longitudinal client health platform for early patient frailty detection, or our automated matching engine that connects carers with available shifts. Across every project, our core goal remains the same: automate away manual data entry so care workers can focus 100% on delivering care.

We cut out bureaucratic handoffs entirely: the engineer who understands the problem designs it, checks it, and ships it in small, fast iterations. If a process step feels like slow overhead without adding real safety, speak up.

Being a Software Engineer at Cera means wearing more hats than usual. You need a strong foundation across the following areas:

• Deep engineering skill to guide and evaluate AI-generated code.

• Domain knowledge in home healthcare or care operations.

• Clear, direct communication with any team across the company.

• True ownership of the business metrics your code is built to improve.

Think of this as a traditional T-shaped role. Engineering is your core depth, but product intuition, UX design, and communication cross the top. Engineers help shape the product vision and anyone building client-facing software is shaping the user experience with the design judgement that comes with that.

Responsibilities

• Run the complete cycle: understand business problems, communicate directly with stakeholders, map out a solution, guide the build, verify it end-to-end, and measure real-world impact.
• Architect before building: Define data models, API schemas, and the failure handling strategies before handing work off to AI agents.
• Guide AI development: Prompt agents, audit their output against intent, security, and performance constraints, and make the final call on what is shipped to production.
• Maintain quality & testing: Write automated tests tailored to risk, use feature flags to test safely in production, and take full ownership of system reliability. Quality is your responsibility.
• Security: Meet the security competencies expected of every engineer, and complete information security and information governance training before you touch production.
• Stay close to users: Work directly alongside branch staff, care teams, and business teams to ensure the software you built solves their actual daily work challenges.
• Own the outcome, not just the deploy: Track the metrics your feature was designed to impact. If the numbers don't move post-launch, investigate and fix it.
• Drive product thinking: Talk to the people you build for, form a view on what's worth building, and bring proposals to the team before anyone asks for them.
• Elevate team tooling: Continually tweak prompts, CI/CD pipelines, and test scaffolding so the entire engineering team benefits.Small improvements compound across everyone who uses them after you.
• Collaborate actively: Participate in architecture discussions, code reviews, and technical architecture decisions across the platform.

Qualifications and skills

We're looking for a Senior Software Engineer with a focus on backend who simplifies, ships, and owns their work. Someone who is equally comfortable navigating new platforms and legacy systems within an organisation such as ours in the care domain.

We are looking for someone with experience in e-commerce, logistics (companies with a strong physical operational component) or SaaS companies.

Core technical foundations

• Data structures & algorithms: Deep core understanding to review and evaluate code effectively.
• Databases at scale: Deep knowledge of database modeling, indexes, query plans, transactions, and multi-tenant isolation patterns, specifically with Postgres at scale.
• Concurrency & failure patterns: Mastery of concurrency, race conditions, and distributed systems failure patterns (idempotency, retries with backoff, circuit breakers, outbox, event sourcing, eventual consistency).
• Architecture & design: Strong background in API design, integration, common design patterns, and Domain-Driven Design (DDD) to slice complex systems into clear domain boundaries.
• Infrastructure: Understanding underlying infrastructure, including connection pools, caching, queues, and container limit behaviors.
• Testing & quality: Solid understanding of testing strategies matched to risk.

Technology stack & domain experience

• .NET / C# expertise: Senior-level mastery of .NET/C#, including real command of the language and runtime to ship across an event-sourced estate.
• Event sourcing & CQRS: Hands-on experience with event sourcing, CQRS, and event streaming in production (e.g., Akka.NET, EventStore, Marten, Kafka).
• Legacy migration instincts: Proven experience lifting production systems off legacy foundations onto new ones using patterns like the Strangler Fig while running parallel bridges safely.
• Multi-tenant architecture: Practical experience designing and implementing multi-tenant architectures.
• Track record of testing mission-critical software in highly regulated domains, such as healthcare or fintech/banking.
• Infrastructure, Kubernetes and Cloud experience is a plus.

Working style & mindset

• Business orientation. You stay close to the people you build for. Ask why before how. You can explain the system you built in business terms, and know what happens operationally when it breaks.
• AI-native by default. Claude Code, Copilot, Cursor, these are already how you work, not tools you're evaluating. You brief agents from a shared account, catch their mistakes before review, and start fresh sessions to avoid context degradation.
• Ownership instinct. You see a problem and take it. You don't wait to be assigned. Prioritise issues yourself and move them forward without needing hand holding.
• Pragmatism. You ship the smallest thing that works, then iterate. Done beats perfect. Prioritise the work that delivers value fastest, then improve it from there.
• Adaptability. You are comfortable when the playbook doesn't exist yet. You drop into

unfamiliar code and contributes within a week or two with support

• Communication. You write clear PR descriptions that explain why. Raises progress and blockers without being prompted.
• Pace. Starts within hours of picking up work. Ask questions early. Ships

incrementally.

• Low ego. You take feedback as information. Ask for help early.

These aren't required, but they'll make you stand out:

• Regulated industry experience (health tech, social care, fintech, defence and homecare). Compliance and audit-aware engineering shortens ramp time.
• NHS-adjacent stack experience: FHIR UK Core, OMOP, SNOMED CT, GP Connect, DTAC.
• Building LLM-powered features in production, evals, drift monitoring, observability.
• Scheduling, matching, or constraint-solving algorithms at production scale.
• Tele-ICU-like, command-centre, or supervised-automation systems from any domain.

General Company Responsibilities

• Equality, Diversity and Inclusion (EDI): Employees are expected to promote and uphold the organisation’s commitment to equality, diversity, and inclusion by fostering a respectful and inclusive working environment.
• Health and Safety: Employees must ensure compliance with health and safety regulations and organisational policies, and take responsibility for their personal safety and the safety of others.
• Training and Development: Employees must engage in all relevant Company mandatory training, workshops, and learning opportunities.
• Policies and Procedures: Employees must adhere to all organisational policies and procedures.