Principal Software Engineer

Job Description:

• Design, build, and operate the clinical decision support and API-driven data delivery platform
• Lead design and implementation of the CDS Hooks platform, including card orchestration, hook context handling, EHR-side logic orchestration, and downstream data service integration
• Own CDS Hook API contracts and evolution, ensuring SMART CDS Hooks compliance and performance and reliability optimization
• Lead technical integration with EMR systems including Epic, NextGen, Athena, and ECW
• Design, build, and maintain public-facing REST and event-driven APIs exposing clinical data, quality metrics, care gaps, attribution data, and decision support content
• Establish API contracts, versioning strategies, and deprecation policies
• Implement API security patterns including OAuth 2.0, scope-based authorization, rate limiting, and audit logging
• Design and optimize real-time or near-real-time data pipelines feeding CDS Hooks and APIs
• Design and implement testing and QA frameworks for CDS Hooks and APIs across EMR systems
• Establish reliability metrics and SLAs for latency, availability, freshness, and API performance
• Define and measure clinical impact metrics including CDS adoption, clinician interaction rates, workflow integration success, and patient outcome influence
• Design and implement monitoring, alerting, failure detection, graceful degradation, and incident recovery
• Partner with Data Reliability Engineering to operate clinical data delivery SLAs
• Establish engineering standards for API design, data schemas, integration patterns, interoperability, documentation, and OpenAPI specifications
• Partner with Data Engineering to align upstream data models, gold-layer datasets, and platform capabilities
• Serve as technical authority on SMART CDS Hooks, FHIR, HL7, CDS Hooks, and EHR integration patterns
• Collaborate with Product, Clinical Operations, and Business stakeholders to translate clinical workflows into platform features
• Advise EMR partners, healthcare systems, and external API consumers
• Ensure CDS and API services comply with HIPAA, state regulations, payer mandates, and other healthcare requirements
• Partner with IT Security and Compliance on access controls, audit logging, encryption, and data protection
• Design and implement audit trails for clinical data access and support compliance audits and reporting
• Mentor team members through design reviews, pairing, and architectural guidance
• Document systems, designs, processes, and procedures

Requirements:

• 8+ years of experience designing, building, and operating API platforms, service-oriented systems, or backend infrastructure at scale
• Demonstrated experience operating at a senior or staff-level individual contributor scope, owning complex systems end-to-end
• 3+ years of direct experience with healthcare data integrations, EMR workflows, clinical data exchange, or healthcare interoperability standards (FHIR, HL7, CDA, claims data)
• 2+ years of hands-on experience with CDS Hooks, SMART on FHIR, or similar clinical decision support APIs
• Strong experience designing and operating REST APIs, including contract design, versioning, error handling, and authentication/authorization patterns
• Deep understanding of healthcare data integrations, EMR workflows, and interoperability patterns (FHIR, HL7, CDS Hooks, SMART on FHIR)
• Expertise in designing for reliability, SLAs, and operational metrics; ability to translate clinical requirements into technical SLOs
• Experience defining and measuring API performance metrics (latency, availability, error rates); familiarity with SLA monitoring and enforcement
• Strong systems thinking with ability to design for scale, reliability, maintainability, and resilience
• Proficiency in modern backend languages (Python, Java, Go, or similar); comfort reading and reviewing code across languages
• Experience with cloud platforms (AWS, Databricks, GCP) and containerized services (Docker, Kubernetes, or managed services)
• Proven ability to partner effectively across engineering, product, analytics, clinical operations, and business teams
• Clear written and verbal communication skills, particularly for explaining technical concepts and tradeoffs to clinicians and non-specialists
• Comfortable working in a fast-moving, ambiguous environment with healthcare compliance and regulatory constraints
• Strong plus: Hands-on experience with CDS Hooks specification and SMART on FHIR implementations in production healthcare environments
• Strong plus: Experience implementing and testing CDS Hooks across multiple EMR systems (Epic, NextGen, Athena, ECW) including clinical workflow validation
• Strong plus: Familiarity with healthcare data formats and standards: FHIR resources (Patient, Condition, Medication, etc.), CCD/C-CDA, claims data (837s, 835s), HL7 v2 or v3
• Strong plus: Experience designing and operating real-time or near-real-time data pipelines feeding clinical applications and decision support systems
• Strong plus: Knowledge of value-based care metrics, care gaps, quality measures (NQF, HEDIS), and HCC/RAF risk stratification
• Strong plus: Experience with API management platforms, developer portals, or partner ecosystem / API monetization patterns
• Strong plus: Familiarity with OAuth 2.0, OIDC, SAML, and federated identity patterns in healthcare systems
• Strong plus: Experience with CI/CD pipelines, infrastructure-as-code, and safe deployment practices
• Strong plus: Background supporting provider-facing platforms or external clinical partners; deep understanding of provider workflows and constraints
• Strong plus: Experience in a healthcare startup or high-growth healthcare technology environment
• Strong plus: Familiarity with healthcare data governance, interoperability regulations (21st Century Cures, ONC rules), and clinical data quality frameworks
• Strong plus: Experience with API testing frameworks and quality assurance for distributed systems

Benefits:

• Competitive base compensation
• Annual bonus potential
• Health benefits effective on start date
• Health & Wellness Program; up to $300 per quarter for your overall well-being available on start date
• 401K plan effective on the first of the month after your start date; 100% of up to 4% of your annual salary
• Unlimited (or generous) paid "Vytal Time", and 5 paid sick days after your first 90 days
• Company paid STD/LTD
• Technology setup
• Ability to help build a market leader in value-based healthcare at a rapidly growing organization