Principal Software Engineer

This is a fully remote position, open to applicants in United States.

📋 Description

• Design, develop, and manage the clinical decision support and API-driven data delivery platform.

• Lead the design and execution of the CDS Hooks platform, encompassing card orchestration, hook context management, EHR-side logic orchestration, and downstream data service integration.

• Oversee the CDS Hook API contracts and their evolution, ensuring compliance with SMART CDS Hooks while optimizing performance and reliability.

• Direct technical integration efforts with EMR systems such as Epic, NextGen, Athena, and ECW.

• Create, develop, and sustain public-facing REST and event-driven APIs that provide access to clinical data, quality metrics, care gaps, attribution data, and decision support content.

• Establish API contracts, implement versioning strategies, and set up deprecation policies.

• Implement API security measures including OAuth 2.0, scope-based authorization, rate limiting, and audit logging.

• Design and enhance real-time or near-real-time data pipelines that feed CDS Hooks and APIs.

• Develop and execute testing and quality assurance frameworks for CDS Hooks and APIs across EMR systems.

• Set reliability metrics and service level agreements (SLAs) for latency, availability, data freshness, and API performance.

• Define and evaluate clinical impact metrics such as CDS adoption rates, clinician interaction levels, workflow integration success, and effects on patient outcomes.

• Create and implement monitoring, alerting, failure detection, graceful degradation, and incident recovery systems.

• Collaborate with Data Reliability Engineering to manage clinical data delivery SLAs.

• Set engineering standards for API design, data schemas, integration patterns, interoperability, documentation, and OpenAPI specifications.

• Work alongside Data Engineering to align upstream data models, gold-layer datasets, and platform capabilities.

• Act as a technical expert on SMART CDS Hooks, FHIR, HL7, CDS Hooks, and EHR integration patterns.

• Partner with Product, Clinical Operations, and Business stakeholders to transform clinical workflows into platform features.

• Provide guidance to EMR partners, healthcare systems, and external API consumers.

• Ensure compliance of CDS and API services with HIPAA, state regulations, payer mandates, and other healthcare standards.

• Collaborate with IT Security and Compliance on access controls, audit logging, encryption, and data protection measures.

• Design and implement audit trails for clinical data access, supporting compliance audits and reporting.

• Mentor team members through design reviews, collaborative programming, and architectural guidance.

• Document systems, designs, processes, and procedures.

⛳️ Requirements

• 8+ years of experience in designing, building, and managing API platforms, service-oriented systems, or scalable backend infrastructure.

• Proven experience operating at a senior or staff-level individual contributor capacity, owning complex systems from start to finish.

• 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 practical experience with CDS Hooks, SMART on FHIR, or similar clinical decision support APIs.

• Strong expertise in designing and operating REST APIs, including contract design, versioning, error handling, and authentication/authorization patterns.

• In-depth understanding of healthcare data integrations, EMR workflows, and interoperability patterns (FHIR, HL7, CDS Hooks, SMART on FHIR).

• Expertise in designing for reliability, service level agreements (SLAs), and operational metrics; skilled at translating clinical requirements into technical service level objectives (SLOs).

• Experience in defining and assessing API performance metrics (latency, availability, error rates); familiar with SLA monitoring and enforcement.

• Strong systems thinking with the ability to design for scalability, reliability, maintainability, and resilience.

• Proficiency in modern backend programming languages (Python, Java, Go, or similar); comfortable with code review across various languages.

• Familiarity with cloud platforms (AWS, Databricks, GCP) and containerized services (Docker, Kubernetes, or managed services).

• Proven ability to collaborate effectively across engineering, product, analytics, clinical operations, and business teams.

• Excellent written and verbal communication skills, especially in conveying technical concepts and trade-offs to clinicians and non-specialists.

• Comfortable operating in a fast-paced, ambiguous environment with healthcare compliance and regulatory constraints.

• Strong plus: Hands-on experience with CDS Hooks specifications and SMART on FHIR implementations in operational healthcare settings.

• Strong plus: Experience implementing and testing CDS Hooks across multiple EMR systems (Epic, NextGen, Athena, ECW), including validation of clinical workflows.

• 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 in designing and managing real-time or near-real-time data pipelines that support 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 strategies.

• Strong plus: Familiarity with OAuth 2.0, OIDC, SAML, and federated identity frameworks in healthcare systems.

• Strong plus: Experience with CI/CD pipelines, infrastructure-as-code, and safe deployment practices.

• Strong plus: Background in supporting provider-facing platforms or external clinical partners; deep understanding of provider workflows and limitations.

• Strong plus: Experience in a healthcare startup or a rapidly growing 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.

• Potential for annual bonuses.

• Health benefits starting on your first day.

• Health & Wellness Program; up to $300 per quarter for overall well-being available from day one.

• 401K plan effective on the first of the month following your start date; 100% match up to 4% of your annual salary.

• Unlimited (or generous) paid "Vytal Time," and 5 paid sick days after your initial 90 days.

• Company-paid short-term and long-term disability insurance.

• Technology setup provided.

• Opportunity to contribute to building a market leader in value-based healthcare within a rapidly growing organization.