Principal Software Engineer - (Java, .Net, Azure & FHIR) - Remote or Hybrid in MN or DC
About The Position
As a Principal Software Engineer specializing in the Payer domain, you will spearhead the development of regulatory-compliant, AI-enhanced solutions for a hybrid Java and .NET ecosystem. Your primary mission is to architect and maintain the mandated CMS Interoperability and Prior Authorization infrastructure on Azure, ensuring seamless data exchange between members, providers, and other payers. If you are located within 30 min of our MN or DC office, you will have the flexibility to work remotely as well as work in the office as you take on some tough challenges. This position follows a hybrid schedule with four in-office days per week.
Requirements
- 5+ years of experience in Java, .NET Core, and Azure cloud-native architecture
- Hands-on experience with HL7 FHIR Implementation Guides (e.g., CARIN Blue Button, Da Vinci PDEX, and Plan Net)
- Deep understanding of CMS-9115-F and CMS-0057-F regulations, including compliance deadlines for 2026 and 2027
- Proven ability to represent technical compliance strategies during CMS audits and stakeholder design reviews
Nice To Haves
- Certifications: Azure Solutions Architect Expert or Professional FHIR Developer certification
- 3+ years of solutions Architecture experience
- AI/ML: Experience implementing MLOps for clinical decision support or fraud detection in payer workflows
Responsibilities
- Design and maintain mandated HL7 FHIR-based APIs, including the Patient Access API, Provider Access API, and Payer-to-Payer API
- Architect the Prior Authorization API to support electronic requests and real-time status updates (ePA) in compliance with CMS-0057-F
- Develop automated systems for annual public reporting of prior authorization metrics (approval/denial rates, decision timeframes)
- Oversee the ingestion and mapping of disparate data sources (claims, encounters, clinical data) into USCDI (United States Core Data for Interoperability) standards
- Utilize Azure Health Data Services to manage and scale FHIR-compliant PHI
- Implement advanced security protocols for third-party application access via OAuth2 and OpenID Connect to satisfy CMS security requirements
- Leverage AI to streamline the 'Responsible AI' processing of prior authorization requests and improve denial reason accuracy for clinical transparency
- Orchestrate a unified architecture for Java (Spring Boot) and .NET Core microservices on Azure Kubernetes Service (AKS)
- Leverage enterprise-approved AI tools to enhance productivity and innovation by streamlining workflows and automating repetitive tasks
- Evaluate emerging trends to drive continuous improvement and strategic innovation
Benefits
- a comprehensive benefits package
- incentive and recognition programs
- equity stock purchase
- 401k contribution
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
What This Job Offers
Job Type
Full-time
Career Level
Principal
Education Level
No Education Listed
