FHIR Integration Engineer

About Us

Abacus Insights is transforming how data and AI work for health plans. Our mission is simple: make healthcare data usable, so the people responsible for care and cost decisions can act faster, with confidence.

As the AI and Data Platform for Payer Intelligence, we help health plans break down data silos to create a single, trusted data foundation. That foundation powers better decisions—so plans can improve outcomes, reduce waste, and deliver better experiences for members and providers alike. Backed by $100M from top investors, we're tackling big challenges in an industry that's ready for change. Our platform enables GenAI use cases by delivering clean, connected, and reliable healthcare data to support automation, prioritization, and decision workflows—and it's why we are leading the way.

Our innovation begins with people. We are bold, curious, and collaborative—because the best ideas come from working together. We embrace the thoughtful use of AI and automation to drive innovation and efficiency, and we look for individuals who are curious and adaptable—those excited to leverage emerging technologies to enhance how we work—while keeping human insight, connection, and our clients at the center of every decision.

Ready to make an impact? Join us and let's build the future together.

About the Role

Healthcare data is only as powerful as it is connected. As a Healthcare Integration Engineer at Abacus Insights, you’ll build the interoperability backbone that makes that connection possible — designing the FHIR-native clinical data platform that lets health plans, providers, and EHR systems finally speak the same language.

This is hands-on, high-impact engineering. You’ll work with Firely Server, the Firely SDKs, and MongoDB to turn decades-old formats like HL7 v2, C-CDA, and X12 into clean, standards-based FHIR resources — served at scale, with low latency, under heavy load. Every API you ship and every pipeline you tune directly shapes how quickly our clients can put their data to work.

You’ll own real architecture decisions, not just tickets. You’ll set the technical direction for how FHIR is implemented at Abacus, partner with Product, Data Engineering, and Security, and see your work land in production, in front of customers, and in the data that powers GenAI use cases across health plans. If you get excited about elegant data models, millisecond query times, and making messy healthcare data behave, you’ll feel right at home.

Note:  This role is based in the US and requires current authorization to work in the United States without the need for employer sponsorship.

Your day to day

• Build the FHIR front door: Design and ship secure, scalable RESTful APIs that live up to the FHIR standard (R4 and US Core), including custom operations, search parameters, and extensions
• Run FHIR at scale: Deploy, configure, and optimize Firely Server (formerly Vonk) and Firely SDK tooling — including custom plugins — to serve high-concurrency clinical data requests
• Model data that performs: Own MongoDB schema design, indexing, and optimization for complex, nested FHIR documents, so queries stay fast as volume grows
• Turn legacy into interoperable: Build and operate ETL/ELT pipelines that ingest, map, and transform HL7 v2, C-CDA, and X12 into standardized FHIR resources
• Chase every millisecond: Profile, load test, and tune across the API, server, and database layers, and architect for low latency and high throughput from day one
• Protect what matters most: Build security in, not on — ensuring every integration meets HIPAA, GDPR, and SOC 2 requirements, with OAuth2/OIDC and SMART on FHIR authorization
• Prove it works: Run end-to-end integration tests and FHIR profile validation (including Firely Forge), and automate conformance checks that catch issues before release
• Ship it and keep it running: Partner with DevOps/SRE to deploy, monitor, and support services in production through containerized, CI/CD-driven workflows on cloud infrastructure

What you bring to the team

• 3+ years in healthcare software engineering, health tech integration, or clinical informatics — you’ve seen how real clinical data behaves
• Deep working knowledge of HL7 FHIR resources, profiles, extensions, and RESTful interactions, including US Core and R4 (STU3 familiarity a plus)
• Hands-on experience with the Firely ecosystem, including Firely Server and the Firely .NET/C# SDKs
• 3+ years with MongoDB, including query optimization, indexing, aggregation frameworks, and document modeling
• Strong backend skills in C#/.NET Core or Node.js/TypeScript, including building services and custom plugins
• A track record of performance tuning and of architecting and designing scalable, high-throughput data services
• Familiarity with EHR integration (Epic, Cerner/Oracle Health, Athenahealth) and standards such as SMART on FHIR, OAuth2, and OIDC
• A working understanding of HIPAA, GDPR, and SOC 2, and the ability to explain technical tradeoffs clearly to engineering, product, and security partners
• Bachelors Degree in Engineering or a related field; or relevant professional experience.

What we like to see, but is not required

• HL7 FHIR certification from HL7 International
• Experience with managed MongoDB-compatible cloud services such as AWS DocumentDB or Azure Cosmos DB for MongoDB API
• Knowledge of containerization (Docker, Kubernetes) and CI/CD pipelines for deployment
• DevOps, SRE, or cloud operations experience — a big plus
• Experience with payer-focused standards and mandates, such as CMS interoperability rules and Da Vinci / CARIN implementation guides
• Curiosity about applying AI and automation to mapping, validation, and data quality workflows

Compensation

Compensation for this role is based on experience, skills, and location, and includes base salary plus eligibility for performance bonuses and equity grants.

What you'll get in return

• Unlimited paid time off – recharge when you need it
• Work from anywhere – flexibility to fit your life
• Comprehensive health coverage – multiple plan options to choose from
• Equity for every employee – share in our success
• Growth-focused environment – your development matters here
• Home office setup allowance – one-time support to get you started
• Monthly cell phone allowance – stay connected with ease

 

Our Commitment as an Equal Opportunity Employer

As a mission-led technology company helping to drive better healthcare outcomes, Abacus Insights believes that the best innovation and value we can bring to our customers comes from diverse ideas, thoughts, experiences, and perspectives. Therefore, we dedicate resources to building diverse teams and providing equal employment opportunities to all applicants. Abacus prohibits discrimination and harassment regarding race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.

At the heart of who we are is a commitment to continuously and intentionally building an inclusive culture—one that empowers every team member across the globe to do their best work and bring their authentic selves. We carry that same commitment into our hiring process, aiming to create an interview experience where you feel comfortable and confident showcasing your strengths. If there’s anything we can do to support that—big or small—please let us know.

AI Use in Recruitment

We use AI-powered tools throughout our recruitment process. This includes Greenhouse's Real Talent Matching Technology, which helps prioritize applications based on job-related criteria, as well as additional AI tools used to support sourcing, interview preparation, and other recruiting tasks. We do not remove the human element—our recruiters and hiring teams review all applications and make all decisions related to candidate progression and hiring, regardless of which tools are used to support that process.