Senior Software Engineer - Interop

Role Description

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

This role is central to supporting HealthMark’s Release of Information (ROI) services. You will work on services 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 handling detailed specs and told to execute—we are looking for someone who can reason through ambiguous interoperability problems, propose pragmatic solutions, and take them all the way to production.

You will have meaningful influence over architecture and technical direction, particularly as we expand our FHIR footprint and modernize how patient data flows through our platform.

AI tools are part of how we build software here. We use AI assisted development daily—not as a novelty, but as a core part of our engineering workflow. We are looking for someone who already works this way and wants to push 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 patterns.
• 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, not just 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 incidents.
• Mentor other engineers, particularly around healthcare integrations and backend service design.

Qualifications

• 6+ years of professional software development experience, with growth in the complexity and scope of problems you have tackled.
• Strong proficiency in the Microsoft 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.
• Solid understanding of relational data modeling, SQL performance, 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 units, integration, and end-to-end testing.
• Fluency with Git and collaborative development workflows.
• Experience deploying and operating services in AWS or Azure.
• Proficiency with CI/CD and DevOps practices.
• Bachelor’s degree in CS or related field, or equivalent hands-on experience.

AI Assisted Development

• Active, daily use of AI coding tools integrated into your development workflow—not just asking a chatbot occasional questions but using AI as a core part of how you write, review, and ship code.
• Ability to critically evaluate AI generated code for correctness, security, and maintainability.
• Experience providing AI tools with meaningful context (codebase access, architecture constraints, project conventions) to get higher quality output.
• At ease in a workplace where AI-supported delivery is the standard rather than a choice.

Preferred Experience

• Deep experience with FHIR resources, profiles, and implementation guides, including real-world interoperability constraints.
• Familiarity with SMART on FHIR, OAuth2, and healthcare authentication/authorization models.
• Experience integrating with major EHR platforms (Epic, NextGen, Meditech, etc.).
• Healthcare domain experience, including HIPAA compliant patient data handling.
• Experience with asynchronous workflows, messaging, and retry semantics for external system integration.
• Hands on AWS experience (EC2, SQS, SNS, Lambda, RDS).
• History of leading technical projects or initiatives.
• Experience with agentic AI workflows—letting AI tools operate with more autonomy while you supervise, review, and direct.

How You Work

• You own outcomes, not just tasks—if something is not working, you fix it or raise it.
• You make decisions with incomplete information and adjust when you learn more.
• You communicate clearly to different audiences: engineers, products, leadership.
• You are open to feedback and can give it constructively to others.
• You have opinions and share them, but you can disagree and commit when the team goes a different direction.
• You see problems beyond your immediate work and do something about them.
• You make other engineers better—through code review, pairing, or just being someone to learn from.
• You see AI tools as something that enhances your abilities, not as something to rely on completely; you make sure you fully understand any code you deliver, no matter how it was created.
• You are comfortable working remotely and managing your own time.

Why This Might Be Interesting/Challenging

• You will work on real world healthcare interoperability problems, not toy examples or greenfield demos.
• Your efforts play a crucial role in retrieving and providing patient records for Release of Information requests.
• You will help shape a growing FHIR based interoperability platform with real scale and impact.
• You will have real ownership and influence over technical direction.
• Small team means your contributions are visible and valued.
• You will work in a shop that takes AI assisted development seriously—as a daily practice, not a buzzword.
• Remote first, results focused on culture that values outcomes over optics.