About the role
Our client is building an AI-based imaging risk-assessment platform that runs automatically against screening exams to help clinicians identify elevated-risk patients earlier. Getting our algorithm in front of clinicians requires more than a good model: it requires a production-grade integration platform that connects directly to hospital EMR and imaging systems and runs reliably and securely inside real clinical workflows.
We’re hiring the first dedicated engineer to own that integration layer end to end: getting imaging studies and reports to and from our algorithm and the hospital’s EMR, all running inside a hospital’s own environment. You’ll be employee number one on this product, working directly with our CTO to take it from its first pilot clinic to a scalable, repeatable integration product.
What you’ll do
- Design and build the core integration pipeline that connects hospital HL7v2 feeds and DICOM/PACS systems to our algorithm and delivers structured results back into the EMR and other viewing modalities.
- Stand up and operate an interface engine deployed on-premises inside hospital environments and own the mapping work required to normalize each hospital’s HL7 feeds into a consistent internal format.
- Build monitoring and automated error detection so issues are caught quickly and clinicians are never left without an expected result.
- Maintain internal audit logging so every study can be traced end to end, supporting both engineering debugging and clinical quality-improvement review.
- Work directly with hospital IT and clinical informatics teams to scope, test, and deploy each new site integration; you will be on calls with hospital interface engineers and informatics leads regularly, not just writing code in isolation.
- Own production reliability for deployed integrations: monitoring, alerting, incident response, and troubleshooting issues that span both our systems and hospital-side infrastructure.
- Partner with our regulatory/clinical team to ensure data handling meets HIPAA and applicable FDA requirements.
- Help define and evolve the integration architecture as the product expands from pilot site to multiple hospitals and additional EMR and viewing platforms.
What you’ll need
Required
- 5+ years of professional software engineering experience, with at least 2–3 years specifically in healthcare interoperability / clinical systems integration.
- Hands-on production experience with HL7v2 messaging; you’ve built or maintained real interfaces handling ADT, ORM, and/or ORU message types, including ACK handling and error/retry logic. Page 1
- Familiarity with DICOM fundamentals and PACS query/retrieve workflows (C-FIND/C-MOVE), or a track record of picking up adjacent imaging/networking protocols quickly.
- Direct experience with at least one HL7 interface engine (Mirth/NextGen Connect, Rhapsody, Cloverleaf, InterSystems, or equivalent).
- Experience integrating with at least one major EMR platform in a production hospital setting; Epic strongly preferred; Cerner/Oracle Health or MEDITECH experience also valued.
- Solid backend engineering skills (Python preferred), and comfort designing and operating services that handle PHI securely.
- Practical experience with on-premises / customer-network deployment models; comfortable operating software inside a hospital’s VPN and change-control constraints, not just deploying to a cloud you control.
- Working understanding of HIPAA technical safeguards and what it means to build software that will undergo hospital security review (encryption at rest/in transit, access controls, audit logging).
- Comfortable working within a regulated, quality-controlled software development process: gated code review, automated testing, and requirement traceability.
- Comfortable being a technical point of contact on calls with hospital IT and clinical informatics teams. This role has real, regular external-facing technical communication, not just internal engineering work.
Strongly preferred
- Prior experience at a health-tech, imaging-AI, or clinical decision-support company that shipped a product that runs inside hospital workflows.
- Experience with radiology or imaging-adjacent workflows specifically (PACS, RIS, dictation/reporting software, or imaging AI orchestration platforms).
- Experience working under FDA medical device quality-system constraints: quality management systems, design controls, or supporting a regulatory submission from the engineering side.
- Working knowledge of FHIR (R4) for querying clinical/demographic data against a production EMR API.
- Experience standing up a new hospital integration from a cold start (first conversation with hospital IT through go-live).
Nice to have
- Experience with Da Vinci Project, SMART on FHIR, CommonWell, or Carequality.
- Exposure to healthcare billing/reimbursement workflows (CPT coding, claims data); helpful but not required for this role’s initial scope.
- Prior startup experience as an early or first specialized engineering hire.
Logistics
- Location: Boston area preferred; hybrid (2-3 days/week in office in Back Bay). Full remote can be considered for exceptional candidates.
- Work Authorization: Must be legally authorized to work in the United States without requiring current or future employer sponsorship for an employment visa.
- Travel: Expect possibility of occasional travel (estimated 1–2 trips per quarter during active pilot phases) to the pilot hospital site and, later, additional hospital sites.
- Reports to: CTO
- Compensation: Competitive base salary plus equity, commensurate with experience.
Why this role
This is a rare chance to own a foundational, high-leverage piece of a clinical AI product from its very first hospital integration. The technical problems are real and hard: HL7 interoperability, DICOM imaging pipelines, on-prem deployment inside hospital networks, and the operational discipline required to run reliably in a clinical environment. But the impact is direct and visible: your integration work is what stands between a validated risk model and a clinician actually seeing that result for a real patient.
How to apply.
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