Lead Backend Engineer

Lead Backend Engineer (healthcare solution)

Location: Remote from Spain (an indefinite Spanish employment contract)

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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, 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 s