FHIR Integration Architect

About the Role
We're building an independent FHIR R4 interoperability layer that lets our CRM's clinical workflows starting with provider launch directly from inside the EHR, beginning with Oracle Health (Cerner) PowerChart. We need someone who can do both halves of this job well: design and personally validate the technical architecture, and lead the engineers full-stack, AI, and QA who build it. This is not a design-and-handoff role. You'll be in the SMART on FHIR launch flow when it breaks, in the code review when a mapping rule is wrong, and in the room when the team needs a call made.
What You'll Own
Architecture & Solution Design
Own the end-to-end architecture of the FHIR layer — SMART on FHIR launch and OAuth2, the canonical data model, the EMR adapter framework, tenant isolation, and event-driven orchestration — and keep it extensible to future EMRs (Epic, athenahealth) and formats (HL7v2, X12) beyond the Cerner pilot.
Make build-vs-buy and vendor decisions (self-hosted HAPI FHIR vs. a managed FHIR store; Keycloak vs. a commercial identity provider; build vs. adopt an interface engine) and can defend the reasoning to both engineers and non-technical stakeholders.
Design the architecture against HIPAA-grade security and auditability requirements from day one — encryption, least-privilege access, audit trails — not as a pre-launch retrofit.
Validate the architecture against real constraints: Oracle Health/Cerner's actual FHIR R4 conformance, US Core and Da Vinci PAS implementation guides, and the operational realities of a live, EHR-embedded launch — not just a reference diagram.
Technical Leadership & Delivery
Lead a cross-functional engineering pod — full-stack engineers, AI/ML engineers, and QA engineers — setting technical direction, running code and design reviews, and removing blockers day to day.
Translate the solution architecture into a sequenced, phased delivery plan (proof of concept → pilot → multi-client scale) and hold the team accountable to it.
Own technical risk — surfacing integration blockers, vendor API gaps, and compliance findings early, and driving them to resolution rather than escalating and waiting.
Integration, Standards & Compliance
Lead the Cerner/Oracle Health integration end to end: SMART App Launch (EHR launch, OAuth2/OIDC, fhirUser claims), Ignite APIs registration, and coordination with the client health system's Cerner administrators.
Define and enforce conformance testing (ONC Inferno, US Core / Da Vinci PAS validation) before any integration is called production-ready.
Partner with compliance and security stakeholders on HIPAA Security Risk Assessments, BAAs, and audit-trail requirements.
Required Qualifications
8+ years in healthcare interoperability or integration engineering, including 3+ years in an architect or technical lead capacity.
Deep, hands-on FHIR R4 experience — resource modeling, RESTful FHIR APIs, and at least one implementation guide (US Core at minimum).
Direct experience implementing SMART App Launch (EHR and/or standalone launch), OAuth2/OIDC, and at least one major EHR's FHIR API — Cerner/Oracle Health experience specifically preferred given Phase 1 scope.
Hands-on experience with HAPI FHIR or an equivalent FHIR server — server customization and multi-tenant partitioning are a strong plus.
Cloud architecture experience on AWS or equivalent: containers, managed relational databases, event-driven services (queues/event buses), and core identity/security services.
Proven experience leading or managing engineers — running reviews, setting direction, and being accountable for a team's delivery, not only your own.
Working knowledge of healthcare data exchange beyond FHIR — HL7v2, X12, CDA — sufficient to plan for future extensibility.
Solid understanding of HIPAA technical safeguards and healthcare data compliance requirements.
Strongly Preferred
Direct, hands-on experience with Oracle Health (Cerner) Millennium / Ignite APIs and PowerChart SMART app registration — or the Epic App Orchard equivalent.
Experience with Keycloak or another open-source identity provider, including custom extension/SPI development.
Familiarity with Da Vinci implementation guides (PAS, CRD, DTR) and FHIR-based prior authorization workflows.
Experience in patient support programs, prior authorization, or healthcare CRM domains.
Experience standing up a healthcare integration function from near-zero on a small team, not only operating within an already-mature enterprise integration group.
Familiarity with applying AI/ML to healthcare data mapping, document generation, or clinical NLP — relevant given the AI engineers on this team.
Tech Stack You'll Work With
Layer
Technologies
FHIR & integration standards
FHIR R4, SMART App Launch v2, US Core, Da Vinci PAS, OAuth2 / OIDC, HL7v2 (future-facing)
FHIR server
HAPI FHIR (JPA server), multi-tenant partitioning
Identity
Keycloak, custom SMART-launch extension (SPI)
Cloud / infra
AWS — Fargate/ECS, Aurora PostgreSQL, DynamoDB, API Gateway, WAF, EventBridge/SQS, Secrets Manager, KMS, CloudWatch/OpenSearch
IaC / delivery
Terraform or AWS CDK, CI/CD (GitHub Actions or CodePipeline), Docker
Target EHR (Phase 1)
Oracle Health / Cerner Millennium (Ignite APIs, PowerChart chart-toolbar launch)
Conformance testing
ONC Inferno test kit (incl. Da Vinci PAS), Synthea synthetic data

Work arrangement
No