EMR Architect (FHIR R4) - Chicago, IL ( Onsite preferred, Remote with travel)

Role: EMR Architect (FHIR R4 Implementation)Location: Chicago, IL ( Onsite preferred, Remote with travel)Duration: Contract to hire / Full-time Remote position | Frequent travel to Chicago, IL | Travel / Hotel / Per Dem - ReimbursedRequired Experience15+ years in healthcare IT with a primary focus on EMR integration and interoperability not a generalist backgroundExperience leading a blended onshore/offshore engineering pod in a client-facing delivery engagementHistory of delivering multi-hospital EMR integration projects against commercial deadlinesClinical decision support (CDS) system architecture or physician-facing application design experienceExperience with AI/ML integration in a clinical context ambient documentation, acuity classification, clinical summarizationCurrent Mirth Connect certification (NextGen Mirth Certified Fundamentals or higher)Epic certification Ambulatory, Inpatient, and/or Orders. Current certifications strongly preferredAWS Certified Solutions Architect or Azure equivalent in a healthcare data contextPMP or equivalent project management certificationPrior experience at a healthcare IT consultancy, EMR vendor, or large health system IT departmentMust-Have Requirements Non-NegotiableHealthcare integration engine production depthMust have built, deployed, and operated a healthcare integration engine (Mirth Connect, Rhapsody, Azure Health Data Services, or equivalent) in a live clinical environment. Not configured templates built channels, transformers, and error handling from code.FHIR R4 hands-on implementationMust have implemented FHIR R4 APIs in a production provider or payer environment. Must be able to name specific FHIR resources, explain ConceptMap usage, and describe how they have handled proprietary EMR code sets that do not map cleanly to SNOMED CT or LOINC.Multi-EMR Integration ExperienceMust have built integration adapters across at least two of: Epic, Cerner/Oracle Health, Meditech. Not evaluated EMRs built production connectors against their APIs in a live hospital environment.Write-back architecture modern approachMust be able to describe a SMART on FHIR write-back implementation OAuth2 scopes, CPOE approval governance, signed order flow, error handling on failed write-back. HL7-era database coordination answers are insufficient.U.S. onshore availabilityMust be U.S.-based and able to work on-site in Chicago at and hospital locations. Regular on-site presence required during Phase 0 sprint and go-live. Tennessee, remote-only, or non-U.S. candidates will not meet client requirements.Available within 2 weeksPhase 0 sprint begins within 5 business days of SOW signature. Candidates who cannot confirm availability within 2 weeks will not be considered.Technical RequirementsIntegration Engines & MiddlewareMirth Connect (NextGen) channel build, JavaScript transformer development, error handling, monitoring (certification preferred)Rhapsody, Azure Health Data Services, or Google Cloud Healthcare API production deployment experience a strong plusInterface engine configuration, version management, and operational governance in a clinical environmentConnector design for both inbound (EMR hub) and outbound (hub EMR) data flowsHealthcare Interoperability StandardsFHIR R4 / US Core production implementation, resource-level depth (Patient, Encounter, Observation, MedicationRequest, Condition, DiagnosticReport, AllergyIntolerance)SMART on FHIR OAuth2 authorization, read and write scopes, token management, EMR-specific scope approval processesHL7 v2.x ADT, ORM, ORU, MDM message types. Interface engine configuration and transformationCCDA clinical document exchange, section mapping, data reconciliationX12 EDI 270/271, 837, 835 (payer integration experience a plus)Clinical vocabulary standards SNOMED CT, LOINC, RxNorm, ICD-10. ConceptMap design and proprietary code set mappingEMR / EHR Platform DepthEpic Interconnect API, Bridges, FHIR R4 sandbox, SMART on FHIR, Ambulatory and Inpatient workflow architecture. Epic certification strongly preferred.Oracle Health / Cerner FHIR R4 Millennium APIs (Ignite), HL7 ADT integration, Open Platform write-backMeditech REST/HL7 connectors for both Expanse (FHIR R4) and legacy MAGIC (HL7 v2). Dual-path adapter design experienceAggregators InterSystems HealthShare, Redox, LK Health. Experience selecting and deploying aggregator platforms for multi-hospital environmentsArchitecture, Engineering & DataDistributed systems architecture API gateway, protocol routing, session cache (Redis), event bus (Kafka or equivalent), normalization engine designHIPAA-compliant system design encryption at rest and in transit, RBAC, immutable audit trail (7-year retention), PHI data residency controlsSQL and Python data validation pipelines, reconciliation, transformation automationCloud platforms AWS or Azure in a healthcare data environment. Azure Health Data Services experience a strong plusSecurity TLS 1.3, OAuth2, VPN, SFTP, NIST 800-53 security controls awarenessAgile delivery sprint planning, backlog governance, Jira or equivalent. Scrum Master certification a plusResponsibilitiesPHASE 0 Architecture & Discovery Sprint (Weeks 1 2)Lead the 10-day architecture and discovery sprint own the deliverables, manage the sessions with end client engineering team, and validate every design decision against the June go-live timelineEvaluate Gen1 EMR target (Epic vs. Meditech) against FHIR R4 maturity, sandbox availability, and hospital credentials produce a formal decision record with aggregator routing recommendation (InterSystems HealthShare, LK Health, Redox)Design the 5-layer integration architecture: Source Systems Adapter Layer Integration Hub Clinical AI Layer Physician ExperienceDefine the adapter contract inputs, outputs, error handling, and version governance so each EMR adapter can be built and replaced independently without touching the hub coreProduce the Data Flow and Normalization Specification pull and push pathways, FHIR R4 resource inventory, clinical vocabulary mapping (SNOMED CT, LOINC, RxNorm, ICD-10), session cache design, event bus architectureDraft the Per-Hospital Onboarding Playbook 10-point checklist templated for 46+ hospitals. Initiate hospital IT CPOE write-back approval process on Day 7 8 this must run in parallel with build, not after.Produce the Risk Register, FR/NFR Specification, and Fixed-Price Phase 1+2 Build Proposal (D-07) all 7 deliverables transferred to on Day 10PHASE 1 Single-EMR Pilot (Weeks 3 6)Lead engineering pod delivery through Phase 1 build Architect Lead is accountable for sprint velocity, quality, and milestone deliveryBuild and deploy the Gen1 EMR adapter configure the integration engine, write and validate transformer logic, test against Epic or Meditech sandboxImplement the pull pathway EMR adapter fetch, FHIR R4 transform, clinical vocabulary normalization, MPI matching, session cache (Redis < 150ms), event bus parallel fetchStand up baseline audit and observability immutable HIPAA audit trail, adapter health dashboards, latency monitoring against < 2s P95 targetDeliver Solution AI feed patient list with acuity classification, session-scoped clinical context, FR-01 through FR-05 completePhase 1 milestone: single-hospital live pull to AI physician interface confirmed, < 2s latency validatedPHASE 2 Writeback & Second Path (Weeks 7 12) Go-LiveImplement signed note and order write-back pipeline physician sign-off gate, no unsigned push, SMART on FHIR write scope management, CPOE approval confirmation per hospitalBuild multi-hospital authentication framework silent MFA across 12+ OAuth2 identity providers, per-hospital credential vault, session sequencingDeploy second EMR adapter or aggregator bridge second EMR type or InterSystems HealthShare / Redox connector, FR-08 aggregator integrationLead UAT end-to-end testing across EMR environments, latency validation against NFR targets, physician UX sign-off, HIPAA audit trail confirmationManage production deployment and hypercare own go-live readiness, hospital IT escalation, and KPI confirmation.Deliver complete codebase, deployment runbooks, and operational documentation to IP transfers in fullONGOING Pod Leadership & Client ManagementLead and manage the 7-person hybrid pod 3 U.S. onshore + 4 India offshore. Sprint planning, backlog governance, daily standups, offshore team coordinationOwn the primary technical relationship with (CTO/COO) architecture decisions, milestone reviews, technical escalation pathSupport Phil Morales on clinical-first framing for (CEO, Physician) architecture must always be presented in terms of physician workflow impactManage hospital IT relationships for CPOE write-back governance navigate approval processes, manage timelines, escalate blockers earlyMaintain architecture governance across all phases enforce adapter isolation, canonical clinical model, human-in-the-loop safety, HIPAA by design