Senior Software Engineer, Voice AI

About the role

Join Natera as a Senior Software Engineer to build and manage our Voice AI platform. This role involves developing real-time conversational AI systems that assist thousands of patients daily with genetic testing inquiries. You will work on the full voice AI stack, from telephony to large language model orchestration, improving patient access to critical health information.

Key facts

What you'll do

• Oversee the complete voice AI architecture, including media streams, LLM orchestration, and text-to-speech output.
• Design and implement multi-agent systems using tool calling, agent handoffs, and shared conversation state for complex patient interactions.
• Build and optimize real-time audio pipelines, managing WebSocket streaming, codecs (mulaw/PCM), voice activity detection, and interruption handling.
• Architect analytics and observability for voice-specific metrics, such as latency, call efficacy, and speech recognition accuracy.
• Address voice-specific challenges like turn-taking, silence detection, barge-in recovery, medical terminology recognition, and end-to-end latency.
• Integrate voice agents with internal services through secure, authenticated APIs.
• Enhance platform reliability by eliminating single points of failure and designing graceful degradation paths.
• Collaborate with product and clinical operations teams to improve self-service rates and reduce call escalations.
• Mentor team members and contribute to architectural decisions for voice AI systems.

Requirements

• 5 or more years of software engineering experience, with at least 2 years focused on production voice AI or conversational AI systems.
• Deep understanding of voice AI pipelines, from telephony to speech-to-text, LLM processing, and text-to-speech.
• Production experience with agentic architectures, including multi-agent orchestration, tool calling, agent handoffs, and real-time state management.
• Strong understanding of voice-specific challenges: VAD tuning, turn-taking, interruption handling, latency budgets, and audio codec management.
• Hands-on experience with telephony systems such as Twilio (media streams, SIP, IVR) or similar WebSocket-based audio streaming platforms.
• Proficiency in TypeScript/Node.js with strong asynchronous programming patterns, and experience with frameworks like NestJS.
• Experience with STT/TTS providers (Deepgram, OpenAI, ElevenLabs, Azure Speech) and knowledge of ASR accuracy for domain-specific vocabulary.
• Production experience with LLM APIs (OpenAI Realtime API, Anthropic Claude) and prompt engineering for conversational agents.
• High autonomy and ability to drive work to completion without extensive supervision.
• Excellent communication skills to explain complex voice AI architecture to non-technical stakeholders.

Nice to have

• Experience in healthcare, biotech, or regulated environments (HIPAA, PHI handling, BAA compliance).
• AWS infrastructure experience (ECS Fargate, Lambda, DynamoDB, Bedrock, Kafka/MSK, API Gateway, CDK).
• Background in real-time systems, including WebSocket lifecycle management and streaming protocols.
• Experience building analytics pipelines for voice/conversational metrics.
• Familiarity with RAG architectures (vector stores, embedding models) for knowledge-grounded voice agents.
• Track record of migrating or evaluating vendor platforms while maintaining production uptime.
• Experience with Datadog APM, LLM Observability, or similar monitoring for AI systems.
• Prior experience in a high-growth startup or zero-to-one product environment.

Skills & tools

• TypeScript
• Node.js
• NestJS
• Twilio
• Deepgram
• OpenAI
• ElevenLabs
• Azure Speech
• Anthropic Claude
• AWS (ECS Fargate, Lambda, DynamoDB, Bedrock, Kafka/MSK, API Gateway, CDK)
• Datadog APM

Practical notes

Natera offers comprehensive benefits including medical, dental, vision, life, and disability plans. Employees and their immediate families receive free genetic testing and fertility care benefits. Other benefits include pregnancy and baby bonding leave, 401k, and commuter benefits. Natera is an Equal Opportunity Employer. All qualified applicants will be considered without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, age, veteran status, disability or any other legally protected status.