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

  • On-site, Remote, Hybrid
    • Cape Town, Western Cape, South Africa
    • Johannesburg, Gauteng, South Africa
    • Cape Town, Western Cape, South Africa
    +2 more
  • ZAR 90,000 - ZAR 115,000 per month
  • Tech & Product

Senior Backend Engineer (.NET/C#) | Remote South Africa | R100k–R115k | Build high-impact healthcare software in a fast-growing, mission-driven startup.

Job description

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If you’ve ever used outdated legacy medical software and thought “there must be a better way,” this is the team making it happen.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

  • 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

Job 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.


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