Lead Backend Engineer (Healthcare Solution)

Location: Remote from Spain (an indefinite Spanish employment contract)Intellias is looking for a Lead Backend Engineer - Healthcare Data Interoperability to join a large-scale digital healthcare initiative focused on connecting fragmented health data and enabling secure, real-time interoperability across the U.S. healthcare ecosystem.This is a hands-on technical leadership role combining deep healthcare interoperability expertise, backend and data engineering, architecture, and team leadership.
You will lead engineers responsible for building and operating real-time interoperability infrastructure connecting EHR/EMR systems, healthcare networks, providers, payers, digital health platforms, and other clinical data sources.The ideal candidate brings strong expertise in FHIR and U.S. healthcare interoperability, together with the engineering depth required to design, build, and operate production systems at scale.Project Overview:The project is building a FHIR-based healthcare data platform that integrates clinical and consumer health information from thousands of healthcare data sources and creates a unified longitudinal health record.The interoperability platform processes high-volume, real-time healthcare data and connects with EHR/EMR systems, HIE/HIN networks, healthcare providers, insurance organizations, pharmacies, wearables, IoT devices, and remote patient monitoring solutions.The engineering ecosystem includes FHIR R4, HL7, REST APIs, Python, Spark, Kubernetes, Kafka and other messaging technologies, SQL/NoSQL databases, and cloud infrastructure .
A key focus of the initiative is compliance with U.S. healthcare interoperability standards and regulations, including US Core, USCDI, SMART on FHIR, CMS interoperability requirements, and national healthcare exchange networks .
The platform is also evolving toward AI-enabled engineering and healthcare capabilities, including practical use of LLMs and modern AI technologies where they can improve data processing, engineering productivity, and platform intelligence.Requirements:8+ years of hands-on software engineering experience, preferably within healthcare interoperability, health data platforms, or HealthTech.5+ years of practical experience with FHIR, including production implementations; strong knowledge of FHIR R4 is required.3+ years of technical leadership experience, leading backend, data engineering, or healthcare interoperability teams.Proven experience designing and operating large-scale, real-time healthcare data exchange solutions .
Deep understanding of FHIR resources, profiles, extensions, terminology, validation, and interoperability patterns.Strong knowledge of US Core Implementation Guide, USCDI, and the U.S. healthcare interoperability ecosystem.Hands-on experience integrating multiple EHR/EMR platforms and working with heterogeneous clinical data sources.Experience implementing Patient Access APIs, Bulk FHIR APIs, or comparable FHIR-based healthcare APIs.Strong knowledge of SMART on FHIR, OAuth 2.0, OpenID Connect, scopes, and healthcare API authorization patterns.Solid understanding of HL7 v2.X, including ADT, ORM, ORU or similar healthcare messaging workflows.Experience with CDA/C-CDA and clinical document exchange.Experience with modern backend frameworks such as Django/FastAPI/Flask, Spring Boot, Node.Js, or .
NET Core .
Experience designing scalable REST APIs and data integration services .
Strong knowledge of API security, including OAuth 2.0, JWT, mTLS, API keys, authentication/authorization, and rate limiting .
Hands-on experience with distributed messaging technologies such as Kafka, RabbitMQ, AWS SQS, Azure Service Bus, or equivalent.Experience with SQL and NoSQL databases, such as PostgreSQL, MySQL, MongoDB, or DynamoDB.Experience designing and operating cloud-native systems using Kubernetes and modern cloud infrastructure.Strong understanding of healthcare data formats including FHIR JSON/XML, HL7, JSON, XML, and CSV .
Proven ability to establish engineering standards, architecture patterns, and technical best practices across teams.Strong leadership and mentoring skills with the ability to remain directly involved in architecture and implementation .
Professional English sufficient for direct collaboration with U.S.-based product, engineering, and business stakeholders.Nice to HaveExperience integrating with major U.S. EHR platforms such as Epic, Oracle Health/Cerner, athenahealth, or similar systems .
Practical experience with U.S. national healthcare exchange networks such as Carequality, CommonWell, eHealth Exchange, or TEFCA-based ecosystems .
Understanding of CMS Interoperability and Patient Access regulatory requirements.Familiarity with ONC certification requirements and related U.S. healthcare interoperability regulations.Experience processing healthcare data at significant scale - hundreds of thousands or millions of patient records.Hands-on experience with Apache Spark, Databricks, Prefect, or comparable data-processing/orchestration technologies.Experience with AWS or Azure cloud-native data and integration services.Experience designing systems handling PHI and other regulated healthcare data, including HIPAA-related security considerations.Practical experience applying LLMs or AI-enabled technologies to data engineering, interoperability, or software development workflows.Experience with AI-assisted engineering tools such as Claude Code, GitHub Copilot, Cursor, or comparable platforms.Responsibilities:Lead the architecture, design, development, and production operation of large-scale healthcare interoperability solutions .
Lead and mentor a team of backend/data engineers responsible for healthcare data pipelines and interoperability infrastructure.Design and evolve FHIR-based APIs and integration services, including Patient Access, Bulk FHIR, and other healthcare interoperability interfaces.Drive technical strategy for FHIR R4, US Core, USCDI, SMART on FHIR, and related interoperability standards.Design scalable real-time data pipelines for ingesting, transforming, validating, and exchanging clinical and healthcare data.Build and maintain integrations with EHR/EMR systems, HIE/HIN networks, healthcare providers, payers, pharmacies, digital health platforms, wearables, and other healthcare data sources .
Establish reusable architecture patterns, technical standards, and engineering best practices for interoperability solutions.Contribute directly to production code, architecture prototypes, complex integrations, and technical proofs of concept .
Design and maintain secure healthcare APIs using modern authentication, authorization, encryption, and API security patterns.Drive technical evaluation and selection of interoperability platforms, frameworks, tools, and technology solutions.Ensure scalability, reliability, observability, security, and regulatory compliance of healthcare data infrastructure.Collaborate closely with product, clinical, engineering, security, data, and business stakeholders to translate interoperability requirements into scalable technical solutions.Coach engineers, conduct technical and architecture reviews, and support professional growth across the team.Apply modern AI-assisted engineering practices where they improve development velocity, data transformation, testing, documentation, troubleshooting, or interoperability workflows.Why this position:This role offers an opportunity to lead one of the most technically and strategically important areas of a modern digital healthcare platform: health data interoperability at scale .
You will work on systems that connect thousands of healthcare data sources and enable clinical information to move securely across a highly fragmented U.S. healthcare ecosystem, directly influencing how healthcare data becomes accessible and useful to patients and healthcare organizations.The position combines technical leadership with hands-on engineering.
You will not only define architecture and engineering standards, but also build critical platform components, solve complex interoperability challenges, and lead engineers working on production systems.You will operate at the intersection of FHIR, healthcare APIs, distributed data systems, cloud native engineering, security, and emerging AI capabilities, with significant influence over both the technical direction of the platform and the engineering team responsible for delivering it.
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