Senior; Principal) EHR Integration Engineer; Remote

Healthcare Interoperability & Clinical Data Infrastructure — USA-Based

At Quadrivia, we have brought together some of the smartest and most passionate people in the sector to work on an ambitious goal: help make healthcare accessible and affordable for everyone on earth, by solving the chronic imbalance between the growing demand for medical care and the constrained supply of clinical skills. While externally we are starting with creating the world's most comprehensive and customizable clinical assistant to deliver routine tasks for clinicians, internally we are pioneering a new way to run a company.

You will design, build, and operate the integration layer that connects the Quadrivia AI platform to the U.S. healthcare ecosystem — EHRs, practice-management systems, labs, HIEs, and national interoperability networks. This means moving clinical data into our AI agents (context, history, orders) and writing AI-generated outputs back into the systems of record, safely and within a highly compliant, HIPAA-governed environment.

This is a deeply hands-on, technical role at the boundary between healthcare standards and modern distributed systems. The integrations you own are the front door to every customer deployment — they directly determine how fast we can onboard a new health system and how much our AI can be trusted with real patient data.

As the integration lead, you will also coordinate multiple integrations running in parallel. As demand grows, integration work is delivered by parallel, ad-hoc teams that spin up around specific customers, EHRs, or go-lives — and you are the technical owner who keeps them aligned, sets the standards they follow, and ensures every concurrent integration lands consistently and on time.

• Design and build resilient, bidirectional integrations with major EHRs (Epic, Oracle Health/Cerner, athenahealth, MEDITECH, Tru Bridge/CPSI, Veradigm/Allscripts, eClinicalWorks, Next Gen).

• Implement and maintain HL7v2 interfaces (ADT, ORU, ORM, SIU, MDM, DFT) and FHIR R4 / US Core integrations, including SMART on FHIR and Bulk FHIR.

• Build and operate integration pipelines on Inter Systems IRIS (our integration platform) — and, where needed, via aggregators like Redox, Health Gorilla, or 1upHealth.

• Handle C-CDA documents, X12 transactions (270/271 eligibility, 837/835 claims), and the connectivity layer (MLLP, SFTP, TLS, VPN, OAuth2 client credentials).

• Navigate EHR vendor programs end-to-end:
  Epic (Showroom/App Orchard, Bridges, Interconnect), Oracle Health CODE, athenahealth Marketplace — including registration, security review, and go-live.

• Own reliability of the integration estate: monitoring, message reconciliation, replay/backfill, dead-letter handling, and clear fallback behavior when an interface or downstream EHR is degraded.

• Guarantee accuracy, patient-matching integrity, and de-identification/PHI handling across every data flow; partner with Security and Compliance on audits.

• Support customer and partner due-diligence and security reviews (questionnaires, BAAs, technical assessments) to quickly unblock access to production data and keep integrations on schedule.

• Coordinate multiple parallel, demand-driven integration teams — assigning work, reviewing designs, unblocking engineers, and keeping standards and timelines consistent across concurrent customer integrations.

• Plan capacity and sequence go-lives across the integration portfolio as ad-hoc teams spin up and down with demand.

• Set integration standards and mentor engineers; act as the organization's technical authority on interoperability.

• Collaborate closely with Backend, AI, Clinical, and Implementation teams to map clinical workflows into integration contracts.

• Write clean,…