Role Overview
Senior Interoperability FHIR Delivery Lead responsible for architecting and operationalizing FHIR-based clinical data exchange platforms supporting CMS interoperability initiatives, enterprise analytics, quality reporting, and risk-adjustment programs.
This role combines hands-on implementation expertise with delivery leadership across transformation pipelines, APIs, and standards frameworks to ensure scalable production-grade interoperability aligned with regulatory and business priorities.
Core Responsibilities
FHIR Architecture and Clinical Exchange Design
Design and implement FHIR-enabled interoperability services supporting:
Patient Access
Provider Access
Payer-to-Payer Exchange
Prior Authorization workflows
quality reporting, analytics, and risk adjustment use cases
Define FHIR resource models, implementation profiles, and transformation frameworks
Establish mapping strategies across HL7, C-CDA, and downstream FHIR delivery environments
API and Transformation Layer Delivery
Work directly with FHIR artifacts including Patient, Coverage, ExplanationOfBenefit, Observation, and related clinical resources
Lead implementation of JSON / NDJSON payload exchanges and Flat FHIR bulk data workflows
Contribute to transformation logic supporting interoperability pipelines
Validate lineage from source ingestion through consumer-facing API exposure layers
Data Platform Integration and Pipeline Enablement
Partner with data engineering teams to enable FHIR resource generation from enterprise data platforms
Support development and optimization of ETL/ELT pipelines supporting interoperability delivery
Ensure consistency across ingestion, transformation, and consumption layers
Maintain traceability supporting regulatory reporting and analytics readiness
Standards Strategy and Regulatory Alignment
Serve as subject matter authority for:
US Core FHIR
Da Vinci Implementation Guides
HL7 v2
C-CDA
X12 interoperability frameworks
Ensure solutions align with CMS interoperability regulations and enterprise compliance controls
Support secure exchange architectures meeting privacy and governance expectations
Cross-Functional Delivery Leadership
Coordinate execution across business stakeholders, enterprise architecture, engineering teams, and interoperability vendors
Establish technical alignment supporting implementation milestones
Drive issue resolution across mapping, transformation, and integration layers
Participate across design, build, validation, and production readiness phases
Data Quality, Governance, and Observability Enablement
Define interoperability-focused data quality controls and transformation validation rules
Support governance frameworks ensuring lineage transparency
Enable monitoring practices across pipelines and API exposure environments
Strengthen observability supporting production-scale interoperability delivery
Required Capabilities
Technical:
Strong hands-on expertise with:
FHIR resource modeling and validation
REST interoperability architectures
JSON payload structures
Flat FHIR bulk data exchange
Experience designing ETL/ELT pipelines supporting FHIR transformations
Advanced SQL supporting mapping validation and diagnostics
Working knowledge of HL7 v2 messaging and C-CDA structures
Functional:
Strong understanding of clinical datasets and exchange patterns
Familiarity with claims, eligibility, and provider datasets across payer–provider interoperability ecosystems
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