About the Role
· We are seeking a Senior Healthcare Interoperability Engineer with deep FHIR and HL7
· expertise to lead our CMS 2027 Interoperability and Prior Authorization Final Rule
· compliance initiative. Initially, you'll integrate with Smile CDR, but we're building
· toward developing our own in-house FHIR server and clinical data repository.
· You'll architect and implement Patient Access API, Provider Access API, Payer-to-Payer
· Exchange, Prior Authorization API, and Provider Directory solutions. This role requires
· someone who can both work with existing tools and build sophisticated healthcare
· interoperability solutions from scratch.
Core 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
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)