Staff Interoperability Engineer - Healthcare Data

We’re seeking an exceptional Interoperability Engineer to design, build, and scale cutting-edge health data exchange solutions. This is a hands-on technical role for a seasoned professional who will own complex integration projects end-to-end. You’ll build real-time data pipelines connecting thousands of healthcare data sources-enabling seamless, secure, and compliant health data exchange for millions of patients. What You’ll Do: Build Large-Scale Interoperability Solutions

• 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

Solve Complex Technical Challenges

• 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

Ensure Security & Compliance

• 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

Collaborate & Innovate

• 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

Do you have experience in XML?, Healthcare Interoperability (Must-Have)

• 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)

FHIR & Healthcare Standards (Deep Knowledge)

• 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

API & Integration Technologies

• 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

Required Technical Skills: Programming & Development

• 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)

Data Engineering & Infrastructure

• 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

FHIR-Specific Skills (Critical)

• 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, * 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

What Makes You Successful:

• Deep technical curiosity and passion for solving complex healthcare data challenges
• Strong debugging skills across multi-system integration issues
• Attention to detail with commitment to data quality and patient safety
• Self-directed with ability to drive projects independently
• Excellent communication with ability to explain technical concepts to non-technical stakeholders
• Collaborative mindset with willingness to mentor and share knowledge
• Adaptability to rapidly changing healthcare regulations and standards
• Security-first mindset with understanding of healthcare data sensitivity

1.81.8 out of 5 stars Remote $150,000 - $220,000 a year, The target salary range for this position is $175,000 - $220,000 and is part of a competitive total rewards package including stock options, benefits, and incentive pay for eligible roles. Individual pay may vary from the target range and is determined by a number of factors including experience, location, internal pay equity, and other relevant business considerations. We review all employee pay and compensation programs annually at minimum to ensure competitive and fair pay.

We’re solving one of healthcare’s biggest problems: fragmented health data.

At b.well, we’ve built the infrastructure that brings together a person’s complete health record-scattered across providers, pharmacies, labs, and apps-into one place.

We operate the largest consumer health data platform. Our interoperability infrastructure processes millions of health records daily, connecting to thousands of data sources nationwide. This is where healthcare interoperability happens at scale-connecting health data from EMRs to wearables to pharmacy systems to insurance claims, all in real-time, all FHIR-native, all compliant.