Principal Software Engineer

Vytalize Health

. Design, build, and operate the clinical decision support and API-driven data delivery platform .

Posted 10/12/2026full-timeRemote • United StatesLeadWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in designing and operating API platforms and clinical decision support systems, with a strong focus on healthcare data integration, interoperability standards, and compliance with healthcare regulations. Proven ability to lead technical integration with EMR systems and optimize API performance metrics.

Highest-signal resume keywords

API Platform DesignHealthcare Data IntegrationCDS Hooks ImplementationREST API DevelopmentEMR System Integration

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

API DesignCDS HooksSMART on FHIRFHIRHL7PythonJavaGoOAuth 2.0CI/CD

Soft Skills

Clear CommunicationSystems ThinkingCollaborationMentoring

Tools & Technologies

AWSGCPDockerKubernetesDatabricks

Industry Keywords

Healthcare ComplianceClinical Data ExchangeInteroperability StandardsValue-Based Care MetricsQuality Measures

Tech Stack

Tools & technologies

AWSCloudDistributed SystemsDockerGoogle Cloud PlatformJavaKubernetesPythonGo

About the role

Key responsibilities & impact

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

What you’ll need

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

Comp & perks

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