Sr Health Interoperability Engineer

Commence is a data-centric healthcare transformation company that combines data-driven solutions, technology, and clinical expertise to improve care efficiency and health outcomes. The Senior Health Interoperability Engineer will establish interoperability ownership, design healthcare data integrations, and lead data modeling across FHIR US Core and OMOP CDM for analytics, research, and population health use cases.

Responsibilities:

• Design and implement FHIR R4-compliant APIs and integration pipelines across EHR systems (Epic and others), federal payers, and commercial health clients, with conformance to US Core Implementation Guide requirements
• Own HL7 v2.x message processing and EDI X12 transaction pipelines (837, 835, 270/271, 278) from architecture through production support
• Build and maintain federal and commercial health data pipelines - with an initial focus on CMS - aligned to the CMS Interoperability Final Rule, Da Vinci Implementation Guides (PDex, PAS, CDex), and TEFCA exchange requirements; scope expands to VA, DHA, and commercial payer integrations over time
• Establish and document HIE integration patterns, federated exchange workflows, and API contract standards for internal and client-facing use
• Model source health datasets - claims, clinical, and administrative - into FHIR US Core resource profiles, ensuring conformance to required and must-support elements across patient, encounter, condition, observation, and related resource types
• Design and maintain mapping logic from proprietary and standard source formats (HL7 v2, EDI, flat file, EHR extracts) to FHIR US Core-compliant representations
• Lead OMOP CDM transformation work: translate FHIR-mapped clinical data into OMOP standard vocabularies and domain tables (Person, Visit, Condition, Drug, Measurement, Observation) to support research and population health analytics use cases
• Build and maintain vocabulary mapping assets (ICD-to-SNOMED, CPT-to-SNOMED, LOINC, RxNorm) required for OMOP conformance and cross-study comparability
• Collaborate with the analytics and data science team to ensure OMOP-structured data is properly exposed for cohort definition, quality measurement, and ML feature engineering
• Partner with the Sr. Data Engineer and Sr. Solutions Architect to embed interoperability and data modeling standards into the core stack: AWS, Databricks, Postgres, and SQL Server
• Author and maintain integration specifications, data dictionaries, mapping documentation, and exchange pattern standards

Requirements:

• 7+ years of hands-on experience in healthcare data exchange and interoperability engineering
• Deep expertise in HL7 FHIR R4 and US Core IG; proficiency with SMART on FHIR authorization patterns
• Demonstrated experience mapping source health data (claims, clinical, ADT) to FHIR US Core resource profiles
• Hands-on experience with HL7 v2.x and EDI X12 transaction processing (837, 835, 270/271)
• Support customer data integrations with HL7v3 C-CDA/CDA/CCD and Document Query/Retrieval of IHE profiles
• Experience with EHR system integrations (Epic, Cerner, or equivalent)
• Working knowledge of OMOP CDM structure, standard vocabulary mapping, and ETL design for clinical data
• Strong SQL and data modeling skills; experience on cloud-based data platforms (AWS/ Databricks preferred)
• Familiarity with the CMS Interoperability Final Rule, 21st Century Cures Act, and TEFCA exchange framework; familiarity with VA, DHA, or commercial payer data exchange environments a plus
• This is a remote position. Candidates must be able to sit, read, work on a computer, and watch a computer screen for extended periods of time. Occasionally required to stand, walk, use hands and fingers, kneel or crouch
• Experience implementing Da Vinci Implementation Guides (PDex, PAS, CDex, HRex)
• Hands-on OMOP ETL work using Databricks, dbt, or equivalent transformation tooling
• AWS experience designing HIPAA-compliant data architectures
• Prior work in federal health environments (CMS, VA, DHA), state Medicaid programs, or commercial payer organizations
• HL7 FHIR certification or equivalent health IT standards credentialing