Senior FHIR / Da Vinci Developer With Hands-On Delivery Experience (Can Write Code)- Remote

Role: Senior FHIR / Da Vinci Developer With Hands-On Delivery Experience (Can Write Code)- Remote - Contract

Duration: 3 4 Months (8 to 10 hours a day)

Must Have Technical/Functional Skills

Title: Senior FHIR / Da Vinci Implementation Architect (CMS-0057-F)

Position Summary

• We are seeking a highly experienced Da Vinci / FHIR Implementation Architect to lead the design, development, and delivery of CMS-0057-F compliance solutions. The ideal candidate will have hands-on experience implementing and deploying Da Vinci CRD (Coverage Requirements Discovery), DTR (Documentation Templates and Rules), and PAS (Prior Authorization Support) APIs using FHIR R4, with proven success integrating payer platforms, utilization management systems, and provider-facing channels.
• This role requires a strong blend of FHIR interoperability expertise, API architecture, payer-domain knowledge, and enterprise system integration experience. The candidate will be responsible for designing and implementing scalable, production-grade solutions that support real-time prior authorization workflows across complex healthcare ecosystems.

Key Responsibilities

FHIR & Da Vinci Implementation

• Lead the implementation of CMS-0057-F compliance solutions leveraging:
• Coverage Requirements Discovery (CRD)
• Documentation Templates & Rules (DTR)
• Prior Authorization Support (PAS)
• Design, develop, and deploy APIs compliant with HL7 FHIR R4 standards.
• Implement SMART on FHIR and CDS Hooks integrations where applicable.
• Ensure interoperability between payer, provider, and external healthcare systems.

API Architecture & Solution Design

• Own end-to-end technical architecture for a multi-API ecosystem supporting CRD, DTR, and PAS workflows.
• Define service boundaries and integration patterns across:
• Claims systems
• Benefits administration systems
• Utilization Management (UM) platforms
• Provider portals and external channels
• Design shared backend services such as:
• Decision engines
• Prior Authorization pre-screeners
• Rules engines
• Eligibility and benefits validation services
• Build highly available, secure, and scalable API platforms suitable for regulated healthcare environments.

Payer System Integration

• Integrate with core payer platforms such as:
• Facets
• Zyter TruCare
• HealthEdge
• QNXT
• GuidingCare
• Other claims, benefits, or UM systems
• Develop and maintain RESTful integration layers and service wrappers.
• Build real-time integrations supporting point-of-order and prior authorization workflows.

Required Qualifications

• 8+ years of software engineering and integration experience.
• 4+ years of healthcare interoperability experience.
• Hands-on implementation experience with:
• Da Vinci CRD
• Da Vinci DTR
• Da Vinci PAS
• Proven delivery experience implementing CMS-0057-F compliance solutions.
• Strong expertise with:
• HL7 FHIR R4
• SMART on FHIR
• CDS Hooks
• REST APIs
• OAuth2/OpenID Connect
• Experience integrating payer systems including Facets, Zyter TruCare, QNXT, HealthEdge, or equivalent platforms.
• Experience building production-grade, high-availability healthcare API solutions.
• Deep understanding of prior authorization, utilization management, claims, benefits, and payer workflows.

Preferred Qualifications

• Experience with cloud platforms (Azure, AWS, or Google Cloud Platform).
• Knowledge of CMS interoperability mandates and healthcare regulations.
• Experience with event-driven architectures and microservices.
• Familiarity with healthcare security frameworks and HIPAA compliance.
• Experience leading enterprise architecture initiatives in payer organizations.