HL7 EMR Implementation

About the role We're building the interoperability layer of [Company]'s electronic medical record — the set of APIs and interfaces that let patient data move safely between our EMR and the rest of the healthcare ecosystem: hospital systems, labs, imaging centers, HIEs, payers, pharmacies, and third-party apps. As a Staff Engineer, you'll own the technical direction of that layer. You'll design and build our HL7 v2 and FHIR APIs, set the standards other teams integrate against, and act as the person the organization turns to when a question starts with "how do we get this data from…" This is a hands-on senior individual contributor role: you'll write code, but your leverage will come as much from architecture, technical strategy, and raising the bar for everyone building against these interfaces. Interoperability is unusually consequential work. A dropped ADT message or a mis-mapped LOINC code is not a cosmetic bug — it can mean a clinician making a decision without a result they should have seen. We're looking for someone who takes that seriously and builds accordingly. What you'll do Design and build our FHIR API surface — a standards-conformant R4 (and forward-looking R5) RESTful API covering the resources our partners and customers depend on: Patient, Encounter, Observation, Condition, MedicationRequest, DocumentReference, DiagnosticReport, and beyond. Own our HL7 v2 interface layer — ADT, ORM/OML, ORU, SIU, MDM, and DFT message flows over MLLP, including acknowledgment semantics, sequencing, retry, and replay. Define the mapping between our internal clinical data model and the wire formats we exchange, and defend that mapping as both sides evolve. Lead terminology and code-system strategy — LOINC, SNOMED CT, RxNorm, ICD-10-CM, CPT — including how we normalize, validate, and version-manage codes across sources. Build for the failure cases first. Design the observability, reconciliation, dead-letter handling, and replay tooling that makes a 3 a.m. interface outage a contained incident rather than a data-integrity investigation. Implement SMART on FHIR authorization and the OAuth 2.0 / OIDC flows that let third-party apps and patient-facing tools access data with appropriate scopes and consent. Drive regulatory conformance work — ONC Health IT Certification criteria, 21st Century Cures Act information-blocking requirements, CMS interoperability rules, and US Core IG conformance — in partnership with our compliance and regulatory teams. Partner with external integration teams at hospital systems, reference labs, and EMR vendors (Epic, Oracle Health, athenahealth, Veradigm) to scope, negotiate, and ship real-world interfaces. Set engineering standards for how the rest of the organization consumes and extends the interoperability layer: API design review, documentation, sandbox environments, and conformance testing. Mentor engineers across the team and grow the depth of HL7 expertise in the org so it doesn't live in one person's head. What we're looking for Required 8+ years building production software, with 4+ years working directly on healthcare data exchange. Deep, practical HL7 v2 experience — you can read a raw pipe-delimited message and tell us what's wrong with it, and you've dealt with the reality that no two senders implement the spec the same way. Substantial FHIR experience: resource modeling, profiling, search parameter design, and conformance testing against an implementation guide. Strong backend engineering skills in [Java / Kotlin / Go / Python / C#] and experience designing APIs that other teams and companies depend on. Experience with distributed systems concerns that HL7 traffic surfaces immediately: idempotency, ordering, exactly-once-ish delivery, backpressure, and eventual consistency across systems you don't control. Working knowledge of HIPAA and PHI handling — encryption, audit logging, minimum necessary access, and BAA obligations. Demonstrated staff-level impact: technical direction that spanned multiple teams, and a track record of making other engineers more effective. Strongly preferred Hands-on work with an interface engine — Mirth/NextGen Connect, Rhapsody, Cloverleaf, Iguana, or an in-house equivalent. C-CDA generation and consumption, and the document-exchange workflows around it. Experience with HAPI FHIR, Firely SDK, or a comparable server framework. FHIR Bulk Data Access ($export) for population-level and payer use cases. Familiarity with IHE profiles (PIX/PDQ, XDS.b, XCA) and network participation via TEFCA/QHIN, Carequality, or CommonWell. Experience shepherding a product through ONC certification. Clinical or clinical-informatics background, or the kind of sustained proximity to clinicians that produces good judgment about workflow.