Sr Health Interoperability Engineer

Commence is a company focused on data-centric transformation in healthcare, aiming to enhance health outcomes through quality data-driven solutions. The Senior Health Interoperability Engineer will act as a technical authority on healthcare data exchange standards, designing integrations across various health systems and managing data modeling for analytics use cases.

Responsibilities:

• Design and implement FHIR R4-compliant APIs and integration pipelines across EHR systems (Epic and others), federal payers, and commercial health clients, with conformance to US Core Implementation Guide requirements
• Own HL7 v2.x message processing and EDI X12 transaction pipelines (837, 835, 270/271, 278) from architecture through production support
• Build and maintain federal and commercial health data pipelines - with an initial focus on CMS - aligned to the CMS Interoperability Final Rule, Da Vinci Implementation Guides (PDex, PAS, CDex), and TEFCA exchange requirements; scope expands to VA, DHA, and commercial payer integrations over time
• Establish and document HIE integration patterns, federated exchange workflows, and API contract standards for internal and client-facing use
• Model source health datasets - claims, clinical, and administrative - into FHIR US Core resource profiles, ensuring conformance to required and must-support elements across patient, encounter, condition, observation, and related resource types
• Design and maintain mapping logic from proprietary and standard source formats (HL7 v2, EDI, flat file, EHR extracts) to FHIR US Core-compliant representations
• Lead OMOP CDM transformation work: translate FHIR-mapped clinical data into OMOP standard vocabularies and domain tables (Person, Visit, Condition, Drug, Measurement, Observation) to support research and population health analytics use cases
• Build and maintain vocabulary mapping assets (ICD-to-SNOMED, CPT-to-SNOMED, LOINC, RxNorm) required for OMOP conformance and cross-study comparability
• Collaborate with the analytics and data science team to ensure OMOP-structured data is properly exposed for cohort definition, quality measurement, and ML feature engineering
• Partner with the Sr. Data Engineer and Sr. Solutions Architect to embed interoperability and data modeling standards into the core stack: AWS, Databricks, Postgres, and SQL Server
• Author and maintain integration specifications, data dictionaries, mapping documentation, and exchange pattern standards

Requirements:

• 7+ years of hands-on experience in healthcare data exchange and interoperability engineering
• Deep expertise in HL7 FHIR R4 and US Core IG; proficiency with SMART on FHIR authorization patterns
• Demonstrated experience mapping source health data (claims, clinical, ADT) to FHIR US Core resource profiles
• Hands-on experience with HL7 v2.x and EDI X12 transaction processing (837, 835, 270/271)
• Support customer data integrations with HL7v3 C-CDA/CDA/CCD and Document Query/Retrieval of IHE profiles
• Experience with EHR system integrations (Epic, Cerner, or equivalent)
• Working knowledge of OMOP CDM structure, standard vocabulary mapping, and ETL design for clinical data
• Strong SQL and data modeling skills; experience on cloud-based data platforms (AWS/ Databricks preferred)
• Familiarity with the CMS Interoperability Final Rule, 21st Century Cures Act, and TEFCA exchange framework; familiarity with VA, DHA, or commercial payer data exchange environments a plus
• Experience implementing Da Vinci Implementation Guides (PDex, PAS, CDex, HRex)
• Hands-on OMOP ETL work using Databricks, dbt, or equivalent transformation tooling
• AWS experience designing HIPAA-compliant data architectures
• Prior work in federal health environments (CMS, VA, DHA), state Medicaid programs, or commercial payer organizations
• HL7 FHIR certification or equivalent health IT standards credentialing