Staff Interoperability Engineer - Healthcare Data

b.well Connected Health is solving healthcare’s fragmentation problem with their FHIR-based health data management platform. They are seeking an exceptional Interoperability Engineer to design, build, and scale health data exchange solutions, enabling seamless and secure health data exchange for millions of patients.

Responsibilities:

• Design and implement real-time health data exchange solutions supporting millions of patient records
• Build Patient Access APIs, Provider Directory APIs, and Bulk FHIR APIs (CMS Interoperability Rule compliant)
• Develop connections to national networks (Carequality, CommonWell, eHealth Exchange, TEFCA)
• Create scalable data pipelines ingesting from EMRs, HIEs, labs, pharmacies, payers, wearables, and IoT devices
• Implement FHIR R4 and US Core Implementation Guide across all integration points
• Build real-time data pipeline infrastructure using Cloud and AI Native tools, Python, Spark and Kubernetes
• Develop custom FHIR resource mappings, transformations, and validation logic for non-standard data sources
• Build HL7 v2.x to FHIR conversion engines at scale
• CCDA conversions to FHIR
• Create automated testing frameworks for FHIR conformance, data quality, and integration validation
• Troubleshoot multi-system integration issues: data mapping conflicts, API failures, patient matching challenges, compliance gaps
• Implement SMART on FHIR authorization (OAuth 2.0, OpenID Connect, backend services)
• Build security controls: mTLS, JWT validation, API rate limiting, audit logging
• Maintain HIPAA, 21st Century Cures Act, and ONC certification compliance
• Implement consent management and granular data sharing controls
• Partner with product, clinical, and engineering teams to define interoperability requirements
• Create technical documentation: API specs, FHIR profiles, data mappings, troubleshooting guides
• Mentor junior engineers through code reviews and knowledge sharing
• Stay current with emerging healthcare interoperability standards and regulations

Requirements:

• 6+ years in healthcare interoperability or health IT
• 4+ years designing and implementing FHIR-based solutions (FHIR R4 required)
• Proven track record building production health data exchange for Millions of patients
• Extensive experience with 5+ EMR platforms (Epic, Cerner, Allscripts, athenahealth, eClinicalWorks, Meditech, NextGen)
• Production experience implementing Patient Access APIs or Bulk FHIR APIs (CMS Rule compliant)
• Production experience with HIE/HIN integrations and national networks (Carequality, CommonWell, eHealth Exchange, or TEFCA)
• Expert-level HL7 FHIR R4: resource models, profiles, extensions, search parameters, bulk data
• Deep understanding of US Core IG (v3.1.1+, v4.0+, v5.0+, v6.0+) and USCDI v1-v4
• Proficiency with SMART on FHIR (OAuth 2.0, OpenID Connect, SMART scopes, backend services)
• Strong knowledge of HL7 v2.x (ADT, ORM, ORU, SIU, MDM messages)
• Experience with CDA/C-CDA documents (parsing, validation, FHIR conversion)
• Understanding of clinical terminologies: SNOMED CT, LOINC, RxNorm, ICD-10, CPT, CVX
• Knowledge of ONC certification, CMS regulations, and 21st Century Cures Act
• Strong experience designing and building RESTful APIs and FHIR APIs at scale
• Proficiency with message queuing (Kafka, RabbitMQ, Event driven systems)
• Experience with API security: OAuth 2.0, JWT, mTLS, rate limiting
• Understanding of microservices, API gateways, and asynchronous processing patterns
• Experience with using AI tools and agents to accelerate engineering best practices & implementation
• Strong Python skills (required) plus one of: Java, JavaScript/TypeScript, Go, C#
• SQL and NoSQL databases: PostgreSQL, MySQL, MongoDB, DynamoDB, Redis
• Data formats: JSON, XML, FHIR JSON/XML, HL7 v2.x, CSV, Parquet
• Data validation: JSON Schema, FHIR Validator, Schematron
• Version control (Git), CI/CD pipelines, automated testing (pytest, JUnit, Jest)
• Distributed data processing: Apache Spark (PySpark, Spark SQL, Spark Streaming)
• Containerization: Docker and Kubernetes (Deployments, Services, Helm)
• Cloud platforms: AWS (preferred), Azure, or GCP
• Data pipeline patterns: ETL/ELT, streaming, batch processing, CDC
• Hands-on experience with FHIR servers
• FHIR validation tools: HL7 FHIR Validator, Inferno, Touchstone
• Custom FHIR profiles, extensions, and implementation guides
• Advanced Interoperability
• Patient matching algorithms, probabilistic matching, MPI systems
• Clinical data quality assessment, profiling, anomaly detection
• Consent management frameworks (FHIR Consent, XACML, DS4P)
• Payer data exchange: claims (837, 835), prior authorization, coverage determination
• Modern FHIR Implementation Guides: Da Vinci Project: PDex, CDex, HRex, DTR, PAS
• Gravity Project: SDOH Clinical Care IG
• CARIN Blue Button for payer data access
• FHIR Questionnaire/QuestionnaireResponse for structured data capture
• Specialized Integration: Wearables/IoT: Apple HealthKit, Google Fit, Fitbit, FHIR Device/Observation
• Pharmacy: NCPDP SCRIPT, Surescripts integration
• Lab data: ORU/ORM messages, LOINC mapping, DiagnosticReport
• Advanced Technical: LLMs/AI for clinical data extraction, normalization, terminology mapping
• Open-source healthcare contributions (HAPI FHIR, Synthea, FHIR Converter)
• HL7 FHIR certification or HL7 working group participation