Mode: C2H (Must be able to convert to Horizon BCBS without sponsorship)
Location: 1st preference will be given to New Jersey, New York located – 3-4 times in client office in a month.
Technical Skills
Healthcare Interoperability: FHIR R4/R5, HL7 v2, C-CDA, ADT, USCDI, SMART on FHIR, TEFCA
Clinical Data: Patient, Provider, Encounter, Claims, Conditions, Observations, Labs, Medications, Procedures, Allergies, Care Plans
Terminologies: SNOMED CT, LOINC, RxNorm, ICD-10, CPT, HCPCS
Integration: REST APIs, API Management, JSON, XML, Kafka/Event Streaming, ETL/ELT
Key Responsibilities
- Lead the architecture and implementation of clinical data integration solutions supporting payer/provider interoperability initiatives.
- Define integration patterns for exchanging clinical information between payers, providers, EHRs, HIEs, laboratories, pharmacies, and other healthcare organizations.
- Design and implement integrations using FHIR R4/R5, HL7 v2, C-CDA/CCDA, ADT, REST APIs, JSON, XML, and other healthcare interoperability standards.
- Develop approaches for ingesting, validating, transforming, normalizing, and distributing clinical data.
- Define mapping between source clinical data and enterprise clinical data models/FHIR resources.
- Support implementation of FHIR APIs, bulk data exchange, event-driven integrations, and clinical data exchange workflows.
- Address data quality, terminology mapping, provenance, reconciliation, and clinical data normalization.
Clinical Data Exchange Platform
- Provide technical leadership for the development and enhancement of an enterprise Clinical Data Exchange Platform.
- Define integration architecture, reusable integration patterns, APIs, data pipelines, and interoperability services.
- Work with data engineering teams to build scalable ingestion and processing pipelines for clinical data.
- Support integration with enterprise data platforms such as Databricks, Snowflake, Microsoft Fabric, or equivalent cloud data platforms.
- Establish mechanisms for tracking clinical data lineage, provenance, source attribution, and data quality.
- Design solutions for both real-time and batch clinical data exchange.
FHIR & API Integration
- Lead implementation of FHIR-based interoperability solutions across clinical and payer domains.
- Provide expertise in key FHIR resources including Patient, Encounter, Practitioner, Organization, Condition, Observation, DiagnosticReport, MedicationRequest, Medication, Procedure, AllergyIntolerance, CarePlan, Coverage, and related resources.
- Develop and review FHIR profiles, implementation guides, mappings, and API specifications.
- Work with API management and integration teams to establish secure and scalable healthcare APIs.
- Support authentication, authorization, consent, security, and audit requirements for clinical data exchange.
Data Mapping & Transformation
- Analyze clinical data from disparate source systems and develop source-to-target mappings.
- Define transformation rules between HL7 v2, C-CDA, FHIR, proprietary formats, and enterprise clinical data models.
- Establish terminology mappings using standards such as LOINC, SNOMED CT, RxNorm, ICD-10, CPT, and HCPCS.
- Identify and resolve clinical data quality and semantic interoperability issues.
- Establish reusable data transformation and validation frameworks.