Lead Backend Engineer

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, 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 Interoperabil