SmarterDx is transforming how health systems use clinical AI to capture the full value of patient care delivered. Built by physician-data scientists and trained on clinically-validated EHR data, our clinical AI platform interprets the nuances behind every patient story and makes clinically-sound recommendations for revenue cycle teams — helping hospitals recover earned revenue, improve quality metrics, reduce denials, and streamline revenue cycle operations. As a Smartian, you’ll help build technology that makes healthcare more accurate, sustainable, and effective for everyone. Learn more at smarterdx.com/careers.
Sr. Integration Engineer
You are a healthcare integration architect with deep expertise in healthcare interoperability and a strong client orientation. You partner directly with health system IT leaders, interface teams, and operational stakeholders to design integrations that are secure, reliable, and aligned to real-world workflows. You blend executive presence with operational humility, able to lead a CIO-level strategy session in the morning and personally debug a malformed HL7 segment in the afternoon. You will lead integrations end to end, from architectural strategy through build, validation, and production support. You excel at both system design decision making as well as direct hands-on build and troubleshooting, and translate complex interoperability concepts into clear, durable solutions that earn client trust.
You are comfortable translating complex HL7 specifications and data transformation logic into language that resonates with technical and non-technical stakeholders alike. Clients trust you not only to solve immediate integration challenges, but to shape scalable interoperability strategies. At SmarterDx, your work will build lasting partnerships with health systems and directly enable our mission of empowering hospitals to tell the most accurate patient stories - because the more accurate the patient record, the better outcomes for the patient and for the hospital.
What You'll Do
- Lead the integration design, development, and validation of robust, scalable interfaces between SmarterDx and hospital/health system customer EHRs (Epic, Cerner, Meditech).
- Serve as the technical expert on customer engagements, guiding architecture discussions with CIOs, Directors of IT, interface and network teams, CDI and Coding leaders, and implementation sponsors.
- Own integrations end to end, including specification development, mapping, configuration, testing strategy, go live planning, and production stabilization.
- Lead data validation and reconciliation to ensure integrity, completeness, and interoperability compliance.
- Design for reliability and observability with monitoring, alerting, traceability, replay strategies, and operational runbooks.
- Lead structured incident response, root cause analysis, and durable remediation for complex production issues, including participation in an after-hours Tier 3 rotation for high-priority support.
- Improve integration operations through automation: streamline repetitive implementation tasks (test harnesses, validation tooling, automated checks, deployment patterns) to increase throughput and reduce risk.
- Monitor evolving interoperability standards and translate them into actionable architectural guidance for SmarterDx and our clients.
- Influence product and platform strategy by advising engineering on schemas, data contracts, mapping approaches, and integration tooling based on field experience.
What You Bring
- You have deep strength in multiple areas below, and can lead in all of them:
- 7+ years building, deploying, and supporting hospital based HL7v2 interfaces at scale, with expert-level understanding of EHR-specific message structure, triggers, acknowledgements, error handling and downstream impacts.
- Advanced interface engine architecture and operations experience, including best practices for modular design, maintainability, performance, and supportability
- Exceptional executive communication skills, able to influence senior health system leaders and confidently represent the company in customer forums, advisory councils, and conferences.
- Proven expertise in scalable database extraction architecture, including performance tuning, indexing strategy, and downstream data validation, with the ability to both guide client teams and execute directly within vendor-approved frameworks for top-market EHR systems.
- Significant experience enabling FHIR R4 APIs/resources and SMART on FHIR workflows.
- Exceptional skill leading critical meetings and creating supporting documentation to align technical and non-technical stakeholders; adept at translating complex technical concepts (like integration tradeoffs, FHIR and HL7v2 message flows, and data mapping logic) into clear business-impact language.
- Demonstrated ability to define plans that succeed; timelines, critical path, risks, mitigations, and measurable success criteria.
- Hands-on experience in languages like JavaScript or Python for message transformation or workflow automation.
- SQL fluency for validation, reconciliation, and troubleshooting across complex datasets.
- Familiarity with data transfer security best practices and standards such as TLS, HTTPS, and VPN configuration
- Autonomy and the confidence to drive process improvements throughout times of ambiguity and changing priorities
Nice To Haves
- Epic Integration Experience: Bridges, Interconnect, Reporting Workbench, Clarity, Chronicles, Caboodle, Cogito
- Deep knowledge of hospital workflows, clinical data structures, semantic interoperability standards, and revenue cycle data flows.
- Advanced Rhapsody architecture and operations experience is strongly preferred
- Experience with EHR data extraction and transfer patterns, including flat file and X12 transfers via SFTP
- Background in clinical informatics or certified health IT credentials (e.g., HL7, FHIR, Mirth Connect, Cloverleaf, or EHR certifications).
- Participation in HL7 or FHIR working groups or contributions to open-source healthcare integration tools.
- Entrepreneurial mindset. Previous experience as an early joiner in a young technology company or evidence that you are scrappy with a builder’s mentality and an unwavering sense of ownership to every challenge
$185,000 - $220,000
#LI-Remote
- Medical, Dental & Vision – Comprehensive plans with leading insurance providers, covering 75% of your premiums, depending on the plan.
- Paid Parental Leave – Generous paid leave to support families through birth or adoption: Up to 12 weeks for parents.
- Remote-First Team – Work from anywhere in the U.S.
- Unlimited PTO & 11 Holidays – So you can relax and recharge.
- 401(k) with Traditional & Roth Options – Tax-advantaged retirement savings through Fidelity with a 4% match.
- Minimal Bureaucracy – A fast-moving, high-impact environment where you can focus on what matters.
- Incredible Teammates! – Work alongside smart, supportive, and mission-driven colleagues.
Skills Required
- 7+ years building, deploying, and supporting hospital-based HL7v2 interfaces at scale
- Expert understanding of EHR-specific message structures, triggers, acknowledgements, error handling, and downstream impacts
- Advanced interface engine architecture and operations experience
- Exceptional executive communication and customer-facing leadership skills
- Expertise in scalable database extraction architecture, performance tuning, indexing strategy, and downstream data validation
- Experience enabling FHIR R4 APIs/resources and SMART on FHIR workflows
- Ability to lead critical meetings and translate technical concepts for technical and non-technical stakeholders
- Ability to define implementation plans, timelines, critical paths, risks, mitigations, and success criteria
- Hands-on experience with JavaScript or Python for message transformation or workflow automation
- SQL fluency for validation, reconciliation, and troubleshooting
- Familiarity with TLS, HTTPS, VPN configuration, and data transfer security practices
- Epic integration experience, including Bridges, Interconnect, Reporting Workbench, Clarity, Chronicles, Caboodle, or Cogito
- Deep knowledge of hospital workflows, clinical data structures, semantic interoperability, and revenue cycle data flows
- Advanced Rhapsody architecture and operations experience
- Experience with flat-file and X12 transfers via SFTP
- Clinical informatics background or certified health IT credentials, such as HL7, FHIR, Mirth Connect, Cloverleaf, or EHR certifications
- Participation in HL7 or FHIR working groups or contributions to open-source healthcare integration tools
- Experience as an early employee at a young technology company or demonstrated entrepreneurial builder mindset
What We Do
Hospitals are under more pressure than ever, yet every day they continue to provide extraordinary care to their communities. At SmarterDx, we're building frontier clinical AI that helps health systems capture the full complexity of patient cases. This isn't AI for AI's sake. Every product we build helps hospitals recover earned revenue, improve quality, reduce denials, and operate more sustainably. Together, we've helped deliver more than $1 billion in value to health systems across the country. If you want your work to have a measurable, meaningful impact on healthcare, consider growing your career with SmarterDx.
Why Work With Us
We're founded by physicians and powered by experts in medicine, machine learning, engineering, and product. Our remote-first team tackles incredibly complex challenges at the intersection of healthcare, AI, and data. If you're energized by solving difficult problems with talented, curious teammates, you'll fit right in.
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