Senior Software Engineer

Senior Software Engineer - Healthcare Integrations
About Aivara Health
Aivara Health is an early-stage, AI-native healthtech company with a live platform and active customers.
You'll lead the design and build of our EHR integration layer — connecting our platform to the practice-management and EHR systems our customers run on, and establishing the FHIR foundation that supports our prior authorization and referral workflows. You'll work directly with the founder and our development team, with real ownership over architecture and sequencing.
What you'll do
Design and build integrations across major practice-management and EHR platforms (AdvancedMD, eClinicalWorks, athenahealth, Epic, and others)
Implement FHIR R4 APIs (Da Vinci PAS, CRD, DTR profiles are a plus) and HL7 v2 interfaces where needed
Build reliable data pipelines for referrals, prior authorizations, eligibility, and patient demographics — with retries, monitoring, and audit trails
Evaluate and, where it makes sense, integrate middleware platforms (Redox, Health Gorilla, 1upHealth, Particle)
Ensure every integration meets HIPAA requirements: PHI handling, encryption, access logging, BAAs
Document integrations so our support and operations teams can troubleshoot without you
Advise the founder on technical feasibility, cost, and sequencing of integration work
What we're looking for
5+ years of software engineering experience, with at least 2 years building healthcare integrations
Strong backend skills in Node.js/TypeScript and Python; you should be productive in both, and comfortable with frameworks like NestJS, Express, Fastify, FastAPI, or Django
Solid SQL and REST API design — PostgreSQL required, MongoDB a plus
Experience deploying and running services on AWS (Azure or Google Cloud experience welcome)
Hands-on experience with at least one major EHR's API or vendor integration program (AdvancedMD, eClinicalWorks, athenahealth, Epic, Cerner/Oracle Health, NextGen)
Working knowledge of FHIR R4, HL7 v2, and X12 EDI transactions (270/271, 278, 837/835)
Experience with browser automation frameworks for integrating with systems that lack APIs
Understanding of the revenue cycle: how prior auths, referrals, eligibility checks, and claims actually flow in a practice
Comfort working in a small, early-stage team with shifting priorities and limited process
Clear written communication; you'll explain technical tradeoffs to a non-technical founder
Nice to have
Experience with vendor sandbox/certification programs (Epic Vendor Services, athenahealth Marketplace)
Familiarity with CMS-0057-F and Da Vinci implementation guides
Prior work with AI/LLM-based document extraction on clinical or payer documents
Startup or founding-engineer experience
Engagement
Initial 3–6 month contract with a defined scope, with the intent to convert to a full-time role as the company grows. Compensation based on experience. Remote, US-based; Central Time overlap preferred.

Work arrangement
Yes