Senior (Principal) EHR Integration Engineer

Job title: Senior (Principal) EHR Integration Engineer

About the Role You will design, build, and operate the integration layer that connects the Quadrivia AI platform to the U.S. healthcare ecosystem — EHRs, practice-management systems, labs, HIEs, and national interoperability networks. This is a deeply hands-on role at the boundary between healthcare standards and modern distributed systems. As the integration lead, you will coordinate multiple integrations running in parallel and set the standards that ad-hoc teams follow to land deployments consistently and on time.

What You'll Do

• Design and build resilient, bidirectional integrations with major EHRs (Epic, Oracle Health/Cerner, athenahealth, MEDITECH, TruBridge/CPSI, Veradigm/Allscripts, eClinicalWorks, NextGen).
• Implement and maintain HL7v2 interfaces (ADT, ORU, ORM, SIU, MDM, DFT) and FHIR R4 / US Core integrations, including SMART on FHIR and Bulk FHIR.
• Build and operate integration pipelines on InterSystems IRIS (our integration platform) — and, where needed, via aggregators like Redox, Health Gorilla, or 1upHealth.
• Handle C-CDA documents, X12 transactions (270/271 eligibility, 837/835 claims), and the connectivity layer (MLLP, SFTP, TLS, VPN, OAuth2 client credentials).
• Navigate EHR vendor programs end-to-end: Epic (Showroom/App Orchard, Bridges, Interconnect), Oracle Health CODE, athenahealth Marketplace — including registration, security review, and go-live.
• Own reliability of the integration estate: monitoring, message reconciliation, replay/backfill, dead-letter handling, and clear fallback behavior when an interface or downstream EHR is degraded.
• Guarantee accuracy, patient-matching integrity, and de-identification/PHI handling across every data flow; partner with Security and Compliance on audits.
• Support customer and partner due-diligence and security reviews (questionnaires, BAAs, technical assessments) to quickly unblock production data and keep integrations on schedule.
• Coordinate multiple parallel, demand-driven integration teams — assigning work, reviewing designs, unblocking engineers, and keeping standards and timelines consistent across concurrent customer integrations.
• Plan capacity and sequence go-lives across the integration portfolio as ad-hoc teams spin up and down with demand.
• Set integration standards and mentor engineers; act as the organization's technical authority on interoperability.
• Collaborate closely with Backend, AI, Clinical, and Implementation teams to map clinical workflows into integration contracts.
• Write clean, test-driven, maintainable code; validate and own all AI-generated code contributions.

What We're Looking For

• Must Have 10+ years in software/integration engineering, with deep, demonstrated expertise building HL7v2 and FHIR integrations in production healthcare environments (including ancillary flows such as imaging/DICOM, scheduling, and ePrescribing/Surescripts).
• Experience coordinating multiple engineers or parallel workstreams across concurrent customers — comfortable keeping standards and delivery consistent in a fluid, demand-driven team structure.
• Must be based in the USA and authorized to work in the U.S. without sponsorship.
• Availability to travel within the USA as needed for customer onboarding, go-lives, and on-site integration work.
• Hands-on experience delivering integrations in healthcare environments and operating in HIPAA-governed settings.