Senior FHIR Backend Developer

Job Description: 

We are seeking a Senior FHIR Backend Developer to design, build, and maintain the FHIR-based APIs that power CMS's FHIR initiatives. This is a hands-on engineering role focused on implementing standards-based healthcare data exchange, with primary responsibility for the services that submit and process the DEQM Summary MeasureReport profile. 

The ideal candidate is a strong backend engineer who has already implemented FHIR R4 resources, profiles, and APIs in production, and who is comfortable working inside CMS implementation guides (IGs) and conformance requirements. This role works closely with the project's Technical Lead and architecture decisions, turning profile and IG requirements into secure, well-tested, production-grade code. 

Basic Requirements: 

• Ability to successfully obtain a U.S. Federal Position of Trust clearance designation. 

• Must reside in and be able to perform work in the United States. 

• Must have lived in the United States for 3 of the last 5 years. 

• A bachelor's degree is required, preferably in computer science, software engineering, information systems, or a related field (equivalent experience considered). 

• 8+ years of backend software engineering experience, including building and maintaining production REST APIs. 

• 3+ years of hands-on experience implementing HL7 FHIR (R4 preferred) resources, profiles, extensions, and RESTful FHIR APIs. 

• Experience building or extending a FHIR server (e.g., HAPI FHIR) or FHIR client integrations in a production environment. 

• Experience implementing API security patterns such as SMART on FHIR, SMART Backend Services, and OAuth 2.0. 

• Strong written and verbal communication skills, including the ability to document technical designs and decisions clearly. 

Additional Qualifications: 

• HL7 FHIR Foundational Implementer certification strongly preferred; candidates actively pursuing it will also be considered. HL7 FHIR Advanced Developer or Advanced Architect certification is a nice-to-have. 

• Experience implementing or consuming Da Vinci Digital Quality Measures (DEQM), the Quality Measure IG, CRMI, or QI-Core. 

• Familiarity with CQL (Clinical Quality Language) as used in digital quality measure logic. 

• Experience with FHIR Bulk Data export/import and large-scale healthcare data processing. 

• Experience standing up automated profile validation and conformance testing in a CI/CD pipeline. 

• Experience with Java-based FHIR implementations (e.g., HAPI FHIR) a strong plus. 

• Prior experience supporting CMS programs, Medicare/Medicaid data exchange, or other federal health IT systems. 

• Familiarity with FHIR Shorthand (FSH) and SUSHI for authoring and testing profiles and implementation guides. 

• Experience participating in HL7 Connectathons or community implementation testing events. 

Responsibilities: 

• Design, build, and maintain backend services that implement the QPP FHIR API, with a focus on conformance to the DEQM Summary MeasureReport profile. 

• Implement FHIR resource validation and profile conformance checks, and integrate them into the QPP CI/CD pipeline. 

• Build and maintain secure, scalable RESTful FHIR endpoints, applying SMART on FHIR / SMART Backend Services and OAuth 2.0 patterns. 

• Partner with the Technical Lead on architecture decisions (ADRs), including DEQM version targeting, canonical URLs, and package versioning. 

• Write and maintain automated unit and integration tests, and contribute to the conformance test suite. 

• Troubleshoot and resolve defects related to data modeling, resource mapping, and FHIR interoperability. 

• Participate in code reviews and contribute to the team's FHIR architecture and technical documentation. 

• Stay current on relevant HL7 FHIR, Da Vinci, and CMS/ONC implementation guide updates that affect QPP. 

• Support Connectathon testing, internal demos, and knowledge-sharing sessions as needed.