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 adecuado 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, wea 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. Strong backend programming skills in

Python , combined with production experience in at least one additional modern language such as Java, TypeScript/JavaScript, Go, or C#. 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 Have Experience 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.

📌 Lead Backend Engineer (healthcare solution) (Madrid)
🏢 Intellias
📍 Madrid