Senior Software Engineer, Health Data & Interoperability

Italic; United States; Remote; USD 200,000 - 250,000; Full time

Benefits offered by this job

Equity

Job summary

Italic is building the identity and consent layer for healthcare in the US. As our second engineer, you’ll own the data pipeline from health information exchange networks, normalize and deduplicate records, and enable secure, patient-authorized access for AI agents across provider systems.

You’ll work directly with the CEO and founding engineer to ship PHI-safe architecture, define data models (FHIR R4), and design APIs and security controls that scale with nationwide data exchange initiatives

Qualifications

• Extensive production experience with TypeScript, Next.js, React and PostgreSQL.
• Several years in health tech, ideally at a digital health company or health data platform.
• Shipped software that handles PHI under HIPAA.
• A security background: threat modeling, secure design review, and hands-on application security.
• Hands-on FHIR R4 work with real clinical data, including the duplicates and messy coding.
• Owned a data model that other teams or companies relied on.

Responsibilities

• Build how we retrieve clinical records from health information exchange networks.
• Own the FHIR R4 data model: normalization, deduplication across sources and provenance.
• Turn clinical records into structured data that AI models and agents can use, with every fact cited to its source.
• Build the APIs that partner developers use to read that data.
• Build the authorization that lets AI agents access records on a patient’s behalf, and own its attack surface.
• Own the security of what you build: threat models, access control, encryption and key management, audit trails and consent.
• Help run our security program, including security reviews, SOC 2 controls and incident response.

Skills

TypeScript

Next.js

React

PostgreSQL

FHIR R4

PHI security

OAuth

Tools

Hono

OpenID Connect

Job description

Italic's mission is to become the default health ID for every American.

We're a venture-backed, stealth company from the founding team behind Getlabs (acq. Function), building the identity and consent layer for healthcare. Our second engineer will own clinical data and agent access ahead of launch in Q1 2027.

The problem

A patient who signs up with a new healthcare organization arrives with years of records spread across every hospital, clinic, and lab they've visited, and that organization sees almost none of it. What does arrive is often wrong: roughly one in five patient records is duplicated or mismatched across systems. The US has no national patient identifier, and Congress has blocked federal funding for one since 1999, so every organization guesses at who a patient is and starts their record over from scratch.

Why now

TEFCA, the federal framework for nationwide health data exchange, went live in late 2023 and now connects more than 10,000 organizations. For the first time, a single patient authorization can reach records across most of the US health system. The rules for that access took effect in August 2026, and only a handful of companies have built on them. The teams that do will shape how clinical data moves in the US for the next decade.

In parallel, AI assistants now fill out healthcare forms and book care for patients, typing in unverified data with no record of what the patient approved. A mistake as small as a mistyped birth date can fail an insurance check or split a patient’s history, so a clinician prescribes a drug that dangerously interacts with one the patient already takes. Assistants need a verified record and the patient’s permission for each action. Italic is building that layer for every provider and agent a patient uses.

Why join now

• You’ll build the system that pulls a patient’s records from thousands of hospitals, clinics, and labs through one authorization, then turns duplicated, inconsistently coded data into a single record our partners can trust.

• You’ll design how AI agents read clinical data and act for patients, with access the patient approves and can revoke.

• You’ll own security from day one, since every record is PHI and every access is patient-authorized.

• We're fully funded, and your work reaches real patients within months of joining.

• As our second engineer and a core member of the founding team, you'll have the scope, equity, and agency that come with it.

The team

• Kyle Michelson, Founder & CEO. Previously founded Getlabs, the largest nationwide platform for at-home diagnostics, raising $50M along the way from top VCs. Signed Labcorp, Quest, Teladoc, Hims & Hers, GRAIL, Providence, and Mayo Clinic before Function acquired the company in 2026.

• Bart Wegrzyn, Founding Engineer. Previously on the founding team of Getlabs. Built and scaled the engineering team for its first four years, creating the technical backbone that served millions of patients and some of the largest healthcare organizations in the country.

• Investors: Backed by leading healthtech VCs and angels who founded and scaled some of the best-known companies in health data and tech.

The role

• Build how we retrieve clinical records from health information exchange networks.

• Own the FHIR R4 data model: normalization, deduplication across sources and provenance.

• Turn clinical records into structured data that AI models and agents can use, with every fact cited to its source.

• Build the APIs that partner developers use to read that data.

• Build the authorization that lets AI agents access records on a patient’s behalf, and own its attack surface.

• Own the security of what you build: threat models, access control, encryption and key management, audit trails and consent.

• Help run our security program, including security reviews, SOC 2 controls and incident response.

You’ll work directly with our CEO and Founding Engineer. We'll write decisions down before we code, build with coding agents every day, and design our docs, APIs, and SDK so another team’s coding agent can integrate Italic without a human reading them.

Our stack

One TypeScript monorepo, written in a functional style: functions and plain data, no classes.

• Language: TypeScript on Node.js

• Frameworks: Next.js and React for web apps, Hono for APIs

• Data: PostgreSQL

• Standards: FHIR, OAuth and OpenID Connect

• Cloud: Vercel, Google Cloud

About you

• Extensive production experience with our core stack: TypeScript, Next.js, React and PostgreSQL.

• Several years in health tech, ideally at a digital health company or a health data platform.

• Shipped software that handles PHI under HIPAA.

• A security background: threat modeling, secure design review, and hands-on application security covering authentication, authorization, secrets and key management, and the OWASP Top 10.

• Hands-on FHIR R4 work with real clinical data, including the duplicates and messy coding.

• Owned a data model that other teams or companies relied on.

Bonus

• Hono in production.

• Working knowledge of LOINC, RxNorm, SNOMED CT and ICD-10-CM.

• SMART on FHIR, OAuth and OpenID Connect, including their attack surface.

• SOC 2 or HITRUST audits, penetration testing or incident response.

• Vercel or Google Cloud in production.

• HIE, TEFCA, Carequality or CommonWell experience.

• C-CDA to FHIR conversion.

• MCP servers, tool calling, or retrieval over clinical data.

• OAuth 2.1 delegation for AI agents.

Location

Remote in the US for now. As the team grows, we'll move in person to Miami or New York, and we'll cover relocation.

Compensation

$200,000-250,000 base salary, plus equity

We are an equal opportunity employer and welcome applicants of every background.