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Agent guide: [/agents.md](https://www.wearedevelopers.com/agents.md). --- # Lead Backend Engineer (Healthcare Solution) - **Company:** Intellias - **Location:** Santiago de Compostela, Spain (Remote available) - **Contract:** Permanent contract - **Skills:** Cerner, Microsoft Access, JavaScript (Programming Language), .NET Framework, Application Programming Interfaces (APIs), Artificial Intelligence, Amazon Web Services, Microsoft Azure, C Sharp (Programming Language), Clinical Data Repository, Hospital Information Systems, Cloud Computing, Cloud Engineering, Information Engineering, Data Integration, Data Transformation, Cursor (Graphical User Interface Elements), Distributed Data Store, Amazon DynamoDB, EHealth, Interoperability, JSON, Python (Programming Language), PostgreSQL, Enterprise Messaging Systems, Microsoft Message Queuing, MongoDB, MySQL, Node.Js, NoSQL, OAuth, RabbitMQ, Openid Connect, Software Tools, Software Engineering, SQL Databases, Systems Integration, TypeScript, Extensible Markup Language (XML), Azure Service Bus, Data Processing, EHR Systems, GitHub Copilot, Fast Healthcare Interoperability Resources, Flask (Web Framework), Large Language Models, Apache Spark, Spring-boot, Software Security, Electronic Medical Records, Backend, Rate Limiting, Fastapi, Kubernetes, Health Level Seven International, Apache Kafka, Data Management, Restful APIs, Data Pipelines, Databricks - **Published:** August 16, 2026 - **Apply:** https://www.buscojobs.com.es/lead-backend-engineer-healthcare-solution-en-santiago-de-compostela-ID-367594529 ## About the Role 8+ years of hands-on software engineering experience, preferably within healthcare interoperability, health data platforms, or HealthTech. 5+ years of practical experience with FHIR, including production implementations; strong knowledge ofFHIR R4is required. 3+ years of technical leadership experience, leading backend, data engineering, or healthcare interoperability teams. Proven experience designing and operatinglarge-scale, real-time healthcare data exchange solutions. Deep understanding of FHIR resources, profiles, extensions, terminology, validation, and interoperability patterns. Strong knowledge ofUS Core Implementation Guide, USCDI, and the U.S. healthcare interoperability ecosystem. Hands-on experience integrating multipleEHR/EMR platformsand working with heterogeneous clinical data sources. Experience implementingPatient Access APIs, Bulk FHIR APIs, or comparable FHIR-based healthcare APIs. Strong knowledge ofSMART on FHIR, OAuth 2.0, OpenID Connect, scopes, and healthcare API authorization patterns. Solid understanding ofHL7 v2.x, including ADT, ORM, ORU or similar healthcare messaging workflows. Experience withCDA/C-CDAand clinical document exchange. Strong backend programming skills inPython, combined with production experience in at least one additional modern language such as Java, TypeScript/JavaScript, Go, or C#. Experience with modern backend frameworks such asDjango/FastAPI/Flask, Spring Boot, Node.js, or . NET Core. Experience designing scalableREST APIs and data integration services. Strong knowledge of API security, includingOAuth 2.0, JWT, mTLS, API keys, authentication/authorization, and rate limiting. Hands-on experience with distributed messaging technologies such asKafka, RabbitMQ, AWS SQS, Azure Service Bus, or equivalent. Experience withSQL and NoSQL databases, such as PostgreSQL, MySQL, MongoDB, or DynamoDB. Experience designing and operating cloud-native systems usingKubernetesand modern cloud infrastructure. Strong understanding of healthcare data formats includingFHIR JSON/XML, HL7, JSON, XML, and CSV. Proven ability to establish engineering standards, architecture patterns, and technical best practices across teams. Strong leadership and mentoring skills with the ability to remaindirectly involved in architecture and implementation. Professional English sufficient for direct collaboration with U.S.-based product, engineering, and business stakeholders. Nice to Have Experience integrating with major U.S. EHR platforms such asEpic, Oracle Health/Cerner, athenahealth, or similar systems. Practical experience with U.S. national healthcare exchange networks such asCarequality, CommonWell, eHealth Exchange, or TEFCA-based ecosystems. Understanding ofCMS Interoperability and Patient Accessregulatory requirements. Familiarity withONC certification requirementsand related U.S. healthcare interoperability regulations. Experience processing healthcare data at significant scale - hundreds of thousands or millions of patient records. Hands-on experience withApache Spark, Databricks, Prefect, or comparable data-processing/orchestration technologies. Experience with AWS or Azure cloud-native data and integration services. Experience designing systems handlingPHI and other regulated healthcare data, including HIPAA-related security considerations. Practical experience applyingLLMs or AI-enabled technologiesto data engineering, interoperability, or software development workflows. Experience with AI-assisted engineering tools such asClaude Code, GitHub Copilot, Cursor, or comparable platforms. ## Description Lead Backend Engineer (healthcare solution)Location: Remote from Spain (an indefinite Spanish employment contract)Intellias is looking for aLead Backend Engineer - Healthcare Data Interoperabilityto join a large-scale digital healthcare initiative focused on connecting fragmented health data and enabling secure, real-time interoperability across the U.S. healthcare ecosystem.This is ahands-on technical leadership rolecombining deep healthcare interoperability expertise, backend and data engineering, architecture, and team leadership.You will lead engineers responsible for building and operating real-time interoperability infrastructure connecting EHR/EMR systems, healthcare networks, providers, payers, digital health platforms, and other clinical data sources.The ideal candidate brings strong expertise inFHIR and U.S. healthcare interoperability, together with the engineering depth required to design, build, and operate production systems at scale.Project Overview:The project is building aFHIR-based healthcare data platformthat integrates clinical and consumer health information from thousands of healthcare data sources and creates a unified longitudinal health record.The interoperability platform processes high-volume, real-time healthcare data and connects with EHR/EMR systems, HIE/HIN networks, healthcare providers, insurance organizations, pharmacies, weaThe engineering ecosystem includesFHIR R4, HL7, REST APIs, Python, Spark, Kubernetes, Kafka and other messaging technologies, SQL/NoSQL databases, and cloud infrastructure.A key focus of the initiative is compliance with U.S. healthcare interoperability standards and regulations, includingUS Core, USCDI, SMART on FHIR, CMS interoperability requirements, and national healthcare exchange networks.The platform is also evolving towardAI-enabled engineering and healthcare capabilities, including practical use of LLMs and modern AI technologies where they can improve data processing, engineering productivity, and platform intelligence.Requirements:8+ years of hands-on software engineering experience, preferably within healthcare interoperability, health data platforms, or HealthTech.5+ years of practical experience with FHIR, including production implementations; strong knowledge ofFHIR R4is required.3+ years of technical leadership experience, leading backend, data engineering, or healthcare interoperability teams.Proven experience designing and operatinglarge-scale, real-time healthcare data exchange solutions.Deep understanding of FHIR resources, profiles, extensions, terminology, validation, and interoperability patterns.Strong knowledge ofUS Core Implementation Guide, USCDI, and the U.S. healthcare interoperability ecosystem.Hands-on experience integrating multipleEHR/EMR platformsand working with heterogeneous clinical data sources.Experience implementingPatient Access APIs, Bulk FHIR APIs, or comparable FHIR-based healthcare APIs.Strong knowledge ofSMART on FHIR, OAuth 2.0, OpenID Connect, scopes, and healthcare API authorization patterns.Solid understanding ofHL7 v2.x, including ADT, ORM, ORU or similar healthcare messaging workflows.Experience withCDA/C-CDAand clinical document exchange.Strong backend programming skills inPython, combined with production experience in at least one additional modern language such as Java, TypeScript/JavaScript, Go, or C#.Experience with modern backend frameworks such asDjango/FastAPI/Flask, Spring Boot, Node.js, or .NET Core.Experience designing scalableREST APIs and data integration services.Strong knowledge of API security, includingOAuth 2.0, JWT, mTLS, API keys, authentication/authorization, and rate limiting.Hands-on experience with distributed messaging technologies such asKafka, RabbitMQ, AWS SQS, Azure Service Bus, or equivalent.Experience withSQL and NoSQL databases, such as PostgreSQL, MySQL, MongoDB, or DynamoDB.Experience designing and operating cloud-native systems usingKubernetesand modern cloud infrastructure.Strong understanding of healthcare data formats includingFHIR JSON/XML, HL7, JSON, XML, and CSV.Proven ability to establish engineering standards, architecture patterns, and technical best practices across teams.Strong leadership and mentoring skills with the ability to remaindirectly involved in architecture and implementation.Professional English sufficient for direct collaboration with U.S.-based product, engineering, and business stakeholders.Nice to HaveExperience integrating with major U.S. EHR platforms such asEpic, Oracle Health/Cerner, athenahealth, or similar systems.Practical experience with U.S. national healthcare exchange networks such asCarequality, CommonWell, eHealth Exchange, or TEFCA-based ecosystems.Understanding ofCMS Interoperability and Patient Accessregulatory requirements.Familiarity withONC certification requirementsand related U.S. healthcare interoperability regulations.Experience processing healthcare data at significant scale - hundreds of thousands or millions of patient records.Hands-on experience withApache Spark, Databricks, Prefect, or comparable data-processing/orchestration technologies.Experience with AWS or Azure cloud-native data and integration services.Experience designing systems handlingPHI and other regulated healthcare data, including HIPAA-related security considerations.Practical experience applyingLLMs or AI-enabled technologiesto data engineering, interoperability, or software development workflows.Experience with AI-assisted engineering tools such asClaude Code, GitHub Copilot, Cursor, or comparable platforms.Responsibilities:Lead the architecture, design, development, and production operation oflarge-scale healthcare interoperability solutions.Lead and mentor a team of backend/data engineers responsible for healthcare data pipelines and interoperability infrastructure.Design and evolveFHIR-based APIs and integration services, including Patient Access, Bulk FHIR, and other healthcare interoperability interfaces.Drive technical strategy forFHIR R4, US Core, USCDI, SMART on FHIR, and related interoperability standards.Design scalable real-time data pipelines for ingesting, transforming, validating, and exchanging clinical and healthcare data.Build and maintain integrations withEHR/EMR systems, HIE/HIN networks, healthcare providers, payers, pharmacies, digital health platforms, wearables, and other healthcare data sources.Establish reusable architecture patterns, technical standards, and engineering best practices for interoperability solutions.Contribute directly toproduction code, architecture prototypes, complex integrations, and technical proofs of concept.Design and maintain secure healthcare APIs using modern authentication, authorization, encryption, and API security patterns.Drive technical evaluation and selection of interoperability platforms, frameworks, tools, and technology solutions.Ensure scalability, reliability, observability, security, and regulatory compliance of healthcare data infrastructure.Collaborate closely with product, clinical, engineering, security, data, and business stakeholders to translate interoperability requirements into scalable technical solutions.Coach engineers, conduct technical and architecture reviews, and support professional growth across the team.Apply modernAI-assisted engineering practiceswhere they improve development velocity, data transformation, testing, documentation, troubleshooting, or interoperability workflows.Why this position:This role offers an opportunity to lead one of the most technically and strategically important areas of a modern digital healthcare platform:health data interoperability at scale.You will work on systems that connect thousands of healthcare data sources and enable clinical information to move securely across a highly fragmented U.S. healthcare ecosystem, directly influencing how healthcare data becomes accessible and useful to patients and healthcare organizations.The position combinestechnical leadership with hands-on engineering.You will not only define architecture and engineering standards, but also build critical platform components, solve complex interoperability challenges, and lead engineers working on production systems.You will operate at the intersection ofFHIR, healthcare APIs, distributed data systems, cloud-native engineering, security, and emerging AI capabilities, with significant influence over both the technical direction of the platform and the engineering team responsible for delivering it. ## Related Videos - [Shipping Faster with Less: Render on Cloud Hosting, AI Workloads, and the Future of DevOps](https://www.wearedevelopers.com/videos/1894-shipping-faster-with-less-render-on-cloud-hosting-ai-workloads-and-the-future-of-devops) - [Tips and Tricks for Working with 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