Senior Software Engineer, Health Data & Interoperability

Italic

4d•$200,000 - $250,000•Remote

About The Position

Italic is hiring its second engineer to build the clinical data and patient-authorized agent access capabilities of its healthcare identity and consent platform. The role focuses on retrieving clinical records from health information exchange networks, consolidating them into a trusted patient record, and enabling partner developers and AI agents to access the data with patient-approved permissions. The engineer will work directly with the CEO and Founding Engineer as a core member of the founding team, with ownership of security for the systems they build. The role is remote in the US for now; as the team grows, the company plans to move in person to Miami or New York and will cover relocation. Compensation is $200,000–$250,000 base salary plus equity.

Requirements

Extensive production experience with TypeScript, Next.js, React, and PostgreSQL.
Several years of health tech experience, ideally at a digital health company or health data platform.
Experience shipping software that handles PHI under HIPAA.
Security background in threat modeling, secure design review, and hands-on application security, including authentication, authorization, secrets and key management, and the OWASP Top 10.
Hands-on FHIR R4 experience with real clinical data, including duplicate records and inconsistent coding.
Experience owning a data model relied on by other teams or companies.

Nice To Haves

Hono experience in production.
Working knowledge of LOINC, RxNorm, SNOMED CT, and ICD-10-CM.
SMART on FHIR, OAuth, and OpenID Connect experience, including knowledge of their attack surface.
SOC 2 or HITRUST audits, penetration testing, or incident response experience.
Vercel or Google Cloud experience in production.
HIE, TEFCA, Carequality, or CommonWell experience.
C-CDA to FHIR conversion experience.
MCP servers, tool calling, or retrieval over clinical data experience.
OAuth 2.1 delegation for AI agents.

Responsibilities

Build the systems used to retrieve clinical records from health information exchange networks.
Own the FHIR R4 data model, including normalization, deduplication across sources, and provenance.
Turn clinical records into structured data usable by AI models and agents, with each fact cited to its source.
Build APIs that partner developers use to read clinical data.
Build authorization that lets AI agents access records on a patient’s behalf, and own the related attack surface.
Own security for the systems built, including threat models, access control, encryption and key management, audit trails, and consent.
Help run the security program, including security reviews, SOC 2 controls, and incident response.
Work directly with the CEO and Founding Engineer, documenting decisions before coding and designing docs, APIs, and SDKs for integration by coding agents.