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, 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 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

📌 Lead Backend Engineer (Álava)
🏢 Intellias
📍 Álava