Integrations Engineer

We are looking for an Integrations Engineer to join Avo’s Engineering Team. This role will be responsible for building and maintaining the connections between Avo and the EHR systems used by our hospital and clinic partners. You will own integration work end-to-end - scoping, building, testing, deploying, and keeping things running in production clinical environments where reliability is non-negotiable.

This role sits on a small, distributed team with distributed engineers across our US and Asia Team. We work async-first. Clear written communication is as important here as clean code. Prior EHR integration experience is not required. We care far more about strong engineering fundamentals, curiosity about the healthcare space, and a willingness to learn a specialized domain.

What You’ll Do

EHR Integration Development

• Build and maintain integrations with Epic, Cerner, and other major EHR platforms using FHIR, HL7, and vendor-specific APIs - we will ramp you up on the specifics
• Own integration work end-to-end: scoping, development, testing, deployment, and ongoing maintenance
• Troubleshoot and resolve integration issues in production clinical environments where reliability is mission-critical, read raw FHIR resources, trace HL7 message flows, and resolve data mapping issues
• Work with hospital IT teams and EHR vendors to support new integration rollouts and navigate certification requirements

Platform Development

• Contribute to product features across Avo’s broader platform, including clinical AI tooling, decision support, and EHR-embedded workflows, as team needs evolve
• Collaborate with product, design, and clinical stakeholders to translate healthcare workflow requirements into clean, reliable code
• Participate in code reviews, providing and receiving constructive feedback

Quality & Compliance

• Write unit and integration tests with a focus on reliability in high-stakes clinical environments
• Proactively identify and resolve bugs, performance issues, and edge cases in integration data flows
• Uphold our security and compliance standards - HIPAA, SOC2, and EHR vendor certification requirements (we will get you up to speed)

Collaboration & Communication

• Contribute to technical discussions, RFC processes, and sprint planning
• Communicate clearly and asynchronously with teammates, implementation partners, and EHR vendor contacts across time zones
• Help document integration patterns and onboard other engineers to EHR tooling as the team grows

The Stack

• Front-end: React, TypeScript, Vite, Tailwind, Jotai
• Back-end: Python, Django, Celery, PostgreSQL, Redis
• Integrations: FHIR R4, HL7 v2, Epic App Orchard, Cerner SMART on FHIR
• Infrastructure: AWS (ECS/ECR), GitHub Actions, Terraform
• AI: OpenAI/Azure LLMs, RAG pipelines

Do you have experience in Software engineering?, * 3-5+ years of professional software development experience

• Proficiency in JavaScript/TypeScript (React) or Python (Django)
• Solid understanding of REST APIs, data modeling, and systems that handle sensitive, high-reliability data
• Strong written communication skills - we are a written-first culture
• Passion and drive to improve the lives of clinicians with the latest technology
• Hustle and the desire to wear many hats in a fast-paced, cross-functional environment
• Startup “get it done” attitude with independent drive and out-of-the-box thinking

Strongly Preferred

• Experience in a high-growth startup or B2B SaaS environment
• Familiarity with HIPAA compliance requirements in a software context
• Familiarity with both our front-end (React/TypeScript) and back-end (Python/Django) stacks
• Comfort with AI-assisted development workflows

Nice-to-Haves

• Prior experience with EHR integrations (Epic, Cerner, or equivalent) using FHIR, HL7, or vendor-specific APIs
• Experience with Epic App Orchard certification or Cerner SMART on FHIR workflows
• Clinical background or experience working closely with clinical teams
• Experience with AWS, Docker, or Terraform
• Experience scaling AI/LLM features in production

3.33.3 out of 5 stars San Francisco, CA Remote $160,000 - $185,000 a year, Pulled from the full job description

• Health insurance
• 401(k) matching
• Paid time off
• Vision insurance
• Dental insurance
• Flexible schedule, * Generous Time Off: Flexible and generous PTO
• Comprehensive Health Plans: Medical, dental, and vision coverage for you and your family
• 401K Matching: Contribution matching to help invest in your future
• Personal Device Allowance: Tax-free funds for personal device usage
• Compensation and Equity: $160,000 - $185,000 base salary and equity

Avo is the leading AI platform for healthcare enterprises, helping clinicians make better decisions, move faster, and improving the quality of patient care. Serving as a central hub for care teams, Avo brings together patient data, clinical knowledge, and AI-powered workflows to support diagnosis, care planning, documentation, orders, and evidence-based decision-making at the point of care.Clinicians today navigate dozens of tabs, applications, datasets, hospital protocols, medical guidelines, and payer policies to deliver high-quality care. Avo changes that.

We are product-obsessed, collaborative, and scrappy, united by a mission to improve healthcare delivery through AI. Our investors include Noro-Moseley Partners, AlleyCorp, Scrub Capital, and several leading hospitals and universities., Impact: Avo’s products run inside hospitals, helping clinicians make better calls at the point of care. The work is real, and the mission is meaningful.

Ownership: You will own your accounts end-to-end and build the CS function from the ground up. Your fingerprints will be on every process.

High Agency: We move fast, trust our people, and avoid bureaucracy.

Great Team: Work alongside a talented, low-ego group of clinicians, engineers, and product folks who care deeply about craft.

Remote-First: Work from anywhere in the US with flexible hours.