Senior Software Engineer (Healthcare Data / FHIR)

Salt Square is a growing outsourcing company providing high-quality software development services to clients across a wide range of industries. Our team is composed of skilled and dedicated professionals delivering innovative solutions that meet and exceed client expectations.

Our mission is to build reliable, scalable, and future-ready digital solutions tailored to each client's unique business needs. We foster a team-first culture where collaboration, continuous learning, and technical excellence are core values. From supporting startups in launching their first products to helping global enterprises scale their operations, we strive to deliver outstanding value on every project.

We are looking for a strong Senior Software Engineer with deep healthcare data and FHIR experience to join a new engagement with a US healthcare interoperability platform. You will work in a hybrid team alongside the client's own engineers and architects, building quality measurement, member insights, and data ingestion capabilities on top of a FHIR-native health data platform. The primary focus is backend and data engineering in Java (TypeScript is also in play), with regular contributions to a React/TypeScript frontend. You will be expected to drive architectural decisions with the client's architects, mentor mid-level developers, and ship production-quality code across the full stack in a regulated, PHI-handling environment.

Typical Responsibilities

• Design and build backend services that ingest, normalize, and query clinical and claims data as FHIR resources through a Common Data Model

• Implement deterministic quality measure logic (HEDIS / NCQA measures, CQL-based specifications) with support for point-in-time recalculation and full data provenance

• Build member cohort and gap-in-care query capabilities backed by Elasticsearch, and the React/TypeScript UI surfaces that expose them

• Develop and harden ingestion pipelines for healthcare source formats (CSV, X12 837 claims, XML, NCPDP fixed-width) with schema validation against FHIR Implementation Guides and client extract guides

• Integrate with EHR and payer FHIR APIs (Epic, Athena, Cerner and similar) and support upcoming payer-to-payer data exchange requirements

• Collaborate closely with the client's platform, data, and clinical acquisition architects; contribute to design decisions rather than only executing them

• Mentor mid-level developers, conduct code reviews, and uphold engineering standards across the team

• Identify and resolve performance bottlenecks, technical debt, and reliability issues proactively

• Participate in Agile sprint ceremonies, contribute to estimation, and communicate blockers and risks early

• Leverage AI-augmented development practices to accelerate delivery and improve code quality

Requirements

• Hands-on production experience with HL7 FHIR (R4): resource modeling, profiles and Implementation Guides, FHIR search, bulk data, and FHIR API integration

• Solid understanding of US healthcare data: clinical vs. claims data, coding systems (ICD-10, CPT, LOINC, SNOMED, RxNorm), and how payer and provider data flows

• Deep proficiency in Java (Spring Boot or equivalent) building and scaling backend services and data pipelines in production; strong TypeScript/Node.js is a plus and can partially substitute

• Strong working knowledge of React.js and TypeScript, able to build, maintain, and review frontend code with confidence

• Experience with data engineering at scale: ETL/ELT pipelines, schema validation, record matching and deduplication, and processing large batch files

• Experience with SQL databases (PostgreSQL or similar), including query optimization and schema design, plus hands-on experience with Elasticsearch or a comparable search engine

• Proven ability to design, build, and document RESTful APIs with attention to versioning, error handling, and contract-first approaches

• Understanding of working with PHI: HIPAA principles, least-privilege access, audit logging, and secure file transfer (SFTP, key-based auth)

• Solid understanding of software design patterns, SOLID principles, and clean architecture

• Version control with Git and experience with collaborative branching strategies

• Agile/Scrum methodology experience with clear communication in English and the ability to work directly with US-based stakeholders

• Active use of AI tools in daily development workflows (Copilot, Claude, Cursor, or similar), not just familiarity but demonstrated integration into how they write, review, and ship code

Differentiators

• Experience with HEDIS quality measures, NCQA specifications, CQL, or Medicare Advantage Star Ratings

• Experience with healthcare EDI formats: X12 837/835, NCPDP, or CCDA/HL7 v2

• Familiarity with FHIR servers and tooling (HAPI FHIR, Google Healthcare API, AWS HealthLake, Firely, or similar)

• Experience applying NLP or LLM-based extraction to unstructured clinical notes, including human-in-the-loop review and provenance tracking

• Cloud experience (AWS, GCP, or Azure) and comfort with Docker and CI/CD pipelines (GitHub Actions or equivalent), not expected to own infrastructure but should not be blocked by it

• Familiarity with microservices architecture and event-driven design patterns

• Experience working in a hybrid client/vendor team, embedded with a client's in-house engineers

What we offer:

• Competitive salary and benefits package.

• 23 days of paid leave.

• Opportunities for professional growth and development.

• A collaborative work environment with talented and dedicated colleagues.

We offer a supportive work environment where your ideas are heard and your contributions make a real difference. If you're passionate about building great products in healthcare, we'd be excited to have you on board.