Role: Senior Healthcare Interoperability Engineer
Location: 100% Remote
Requirements (Must Have):
· Strong C# developer (7+ years) building complex APIs in .NET 8.0 or higher
· Deep FHIR expertise: FHIR R4 specification, resource modeling, profiles, extensions, Implementation Guides
· CMS Interoperability Final Rule knowledge: Patient Access, Provider Access, Payer-to-Payer, Prior Authorization requirements
· Da Vinci FHIR IG experience: PDex, CDex, PAS (Prior Authorization), HRex, DTR (Documentation Templates and Rules)
· Proven experience building FHIR-compliant APIs from scratch (not just configuration)
· HL7 v2.x and HL7 v3 expertise: message structure, parsing, validation, transformation (especially X12 278 for prior auth)
· US Core Data for Interoperability (USCDI) v3/v4 implementation
· SQL Server expertise: complex queries, stored procedures, performance tuning, healthcare data modeling
· Experience with clinical terminologies (LOINC, SNOMED CT, RxNorm, ICD-10, CPT, HCPCS)
· Familiar with Azure services (App Service, API Management, Service Bus, Key Vault)
· Understanding of FHIR server internals: resource persistence, search parameters, indexing strategies
Note: This role requires deep expertise in CMS 2027 compliance requirements including all four mandated APIs (Patient Access, Provider Access, Payer-to-Payer, Prior Authorization) plus Provider Directory. Experience with Da Vinci FHIR Implementation Guides and payer operations is highly valued. We need someone who can both integrate with Smile CDR AND architect custom FHIR infrastructure for long-term sustainability.
Preferred Skills (Nice to Have):
Smile CDR & FHIR Repositories:
· Hands-on Smile CDR configuration, customization, and integration
· Linux system administration for healthcare applications
· Smile CDR module configuration (FHIR Storage, Subscriptions, Security)
· Custom interceptor development for business logic
· Experience with other FHIR servers (HAPI FHIR, Firely Server, Azure API for
FHIR)