5-7 years of experience in Epic FHIR integration and implementation.
Demonstrated expertise in developing production-level FHIR write paths and ensuring data validation.
Experience with SMART on FHIR, particularly OAuth 2.0 and US Core R4 standards.
Proficiency in Epic client ID registration and multi-organization onboarding processes.
Ability to navigate security and informatics reviews in a healthcare setting.
Strong backend development skills, particularly with AWS, focusing on schema-level correctness.
Responsibilities
Build a reusable SMART on FHIR launch compatible with any Epic organization.
Implement comprehensive read context for clinical measurements.
Create an efficient write path for clinical data observations and reports.
Develop backend services for verification and reporting of filing usage.
Design a multi-tenant configuration for scalable integration across health systems.
Lead the registration and onboarding of new vendor services and health systems.
Deliver a validated non-production Epic environment launch within 60 days.
Benefits
Flexible remote work arrangement with required overlap to US hours.
Contract-to-hire position offering a clear path to full-time employment.
Opportunity to work on high-impact integration projects in large health systems.
Potential for involvement with cutting-edge healthcare technologies and standards.
Full Job Description
Epic / FHIR Integration Engineer
Location: Remote (US hours overlap required) Type of Role: Contract-to-Hire Contract Term: 3 months, then convert to full-time
Overview
A healthcare technology company is seeking an Epic / FHIR Integration Engineer to own the Epic integration for a clinical measurement platform currently running in production at some of the largest health systems in the country. The platform captures objective clinical data and files results directly into the patient's chart. This engineer will own the Epic integration end to end - the SMART on FHIR build, the write path, and site-by-site rollout across an expanding portfolio of health system partners - building a reusable Epic app so that future health system partners can activate the integration far more easily than the custom, one-off integrations built in the past.
Key Responsibilities
Build a standard SMART on FHIR launch (OAuth 2.0 authorization code with PKCE, US Core R4), designed to be portable to any Epic organization rather than tied to a single customer.
Implement expanded read context - authorizing order, prior observations, active medications, department, and rendering provider - to ensure clinical measurements carry full clinical meaning.
Build the write path: discrete observations, a results report, and supporting data playback, with confirmed persistence and structurally enforced idempotency (not handled in application logic alone).
Develop a backend service client for filing verification and utilization reporting, separate from the point-of-care application.
Design multi-tenant configuration - a single integration and code system, configurable per organization and per department, with no forked builds per customer.
Lead Vendor Services registration and site onboarding, including scope activation, security review, and informatics conversations at each new health system.
Deliver a standard, non-production Epic environment SMART launch within the first 60 days, including a validated end-to-end path for filing observations and a defined test strategy.
Navigate real-world non-production environment constraints as a core part of the role.
Required Experience & Skills
Production Epic FHIR write-path delivery - discrete observations/results filing, persistence validation, and structurally enforced idempotency.
SMART on FHIR engineering - OAuth 2.0 authorization code with PKCE, US Core R4, and portable Epic app design.
Epic implementation and onboarding - client ID registration, Vendor Services coordination, security/informatics review, and activation across multiple health systems.
Proven experience shipping a FHIR write path into Epic in a live production environment at a real health system (read-only integrations or work done entirely behind a middleware abstraction do not qualify).
Experience building a SMART on FHIR EHR launch from scratch, including OAuth 2.0 authorization code with PKCE and US Core R4 conformance.
Experience with Epic client ID registration and per-customer activation at more than one organization.
Experience carrying an integration through a health system's security and informatics governance review process.
Backend ownership experience, including production services on AWS, with a strong instinct for enforcing correctness guarantees at the schema level rather than in bypassable application code.
Strong communication skills for representing technical work during health system security and informatics discussions.
Ability to work independently in a remote, US-hours-overlap role.
Nice to Have
Ex-Epic employee, or Epic certification.
Terminology work experience - LOINC or SNOMED mapping, publishing a FHIR CodeSystem with a canonical URI.
Experience with Mayo Clinic Platform or another EHR vendor platform program.
Experience helping secure a Connection Hub or Showroom listing.
Native iOS experience, or experience handing off an integration into a mobile app.
Hands-on experience using AI coding tools as part of the development workflow.
Explicitly Not Part of This Role
Revenue cycle and charge capture configuration (handled by a separate advisor).
Owning terminology mapping decisions (handled by a separate advisor).
Computer vision and pose estimation work (handled in-house).
