C# FHIR Developer/Engineer

MUST BE US CITIZEN OR GREEN CARD HOLDER AND LOCATED IN THE FOLLOWING STATES

AL, AR, FL, GA, IN, LA, MI, MS, NC, OK, PA, SC, TN, TX, UT, WI, MD, VA

MUST HAVE EXPERIENCE WITH FHIR

Senior Software Engineer – Interoperability Platform

Role and Responsibilities

We are hiring a Senior Software Engineer to help design, build, and evolve an interoperability platform responsible for securely retrieving patient records from EHRs and external healthcare systems using FHIR-based APIs and related interoperability standards.

This role focuses on building and maintaining systems that locate, retrieve, normalize, and deliver patient data at scale, ensuring reliability, auditability, and compliance in a complex healthcare ecosystem.

You will work across modern services and legacy integrations, collaborating with a small, highly engaged team in a fully remote environment. This is not a role where you are handed detailed specifications and asked to execute. We are looking for someone who can reason through ambiguous interoperability challenges, propose pragmatic solutions, and take them all the way to production.

You will have meaningful influence over architecture and technical direction, particularly as the platform expands its FHIR footprint and modernizes how patient data flows through the system.

AI tools are part of how we build software. AI-assisted development is used daily—not as a novelty, but as a core part of the engineering workflow. We are looking for someone who already works this way and wants to push it further.

What You Will Do

• Design, build, and maintain backend services and APIs that retrieve and process patient records from EHRs and health systems using FHIR (R4) and related interoperability standards.
• Build and evolve interoperability workflows that support Release of Information (ROI) use cases, including patient identity matching, record discovery, data retrieval, and downstream delivery.
• Integrate with external healthcare systems, EHR vendors, and health information networks using FHIR, RESTful APIs, and event-driven architectures.
• Work across modern .NET services and existing platforms, modernizing legacy integrations where appropriate.
• Own technical roadmaps for interoperability components—balancing reliability, scalability, compliance, and delivery speed.
• Use AI coding tools daily to accelerate development—generating code, debugging, refactoring, and navigating unfamiliar healthcare-focused codebases.
• Review AI-generated output with the same rigor applied to any production code—understanding what it produces rather than blindly accepting it.
• Write clean, testable, well-documented code with a strong emphasis on observability and operational readiness.
• Lead code reviews and help maintain engineering standards across backend services and integrations.
• Debug and resolve issues across distributed systems, including third-party integrations and external dependencies.
• Collaborate with product, operations, and compliance teams to translate healthcare and ROI requirements into technical solutions.
• Identify risks related to data quality, external system dependencies, and interoperability constraints before they become production incidents.
• Mentor other engineers, particularly around healthcare integrations and backend service design.

What We Are Looking For

Experience

• 6+ years of professional software development experience, with increasing complexity and scope of problems solved.
• Strong proficiency in the Microsoft technology stack:
• C#
• .NET Framework / .NET 6+
• ASP.NET Web API
• ASP.NET MVC
• Entity Framework
• SQL Server
• Experience building and operating API-driven distributed systems in production environments.
• Direct experience with healthcare interoperability, particularly FHIR-based integrations.
• Strong understanding of relational data modeling, SQL performance optimization, and data consistency in integration-heavy systems.
• Experience integrating with third-party systems where reliability, error handling, and observability are critical.
• Demonstrated automated testing practices across unit, integration, and end-to-end testing.
• Fluency with Git and collaborative development workflows.
• Experience deploying and operating services in AWS or Azure environments.
• Proficiency with CI/CD pipelines and DevOps practices.
• Bachelor’s degree in Computer Science or related field, or equivalent hands-on experience.