Design, develop, and maintain scalable backend applications using PHP and Laravel. Build RESTful APIs, PostgreSQL schemas and queries, third-party integrations, automated tests, and Dockerized services across AWS. Monitor application health, troubleshoot defects, participate in code reviews, improve CI/CD workflows, and document technical processes. Collaborate with product, frontend, QA, and DevOps teams in a remote Agile/Scrum environment to deliver reliable software supporting clinical workflows.