Cotiviti

Compensation

Full Description

Overview We are seeking a Principal Interoperability Engineer with deep expertise in FHIR and Clinical Quality Language (CQL), combined with strong software engineering skills in .NET. The ideal candidate will design, implement, and optimize advanced healthcare interoperability solutions, translating complex clinical and quality measure logic into efficient, maintainable, high-performance code. This role requires both strategic technical leadership in interoperability standards and hands-on software engineering excellence. You will work closely with product managers, architects, and engineering teams to ensure compliance with healthcare regulations, data privacy requirements, and industry standards, including HL7, FHIR, C-CDA, and related APIs. Responsibilities Architecture & Strategy: Lead the design and implementation of FHIR-based interoperability architecture for digital quality measurement solutions aligned with NCQA standards. FHIR/CQL Subject Matter Expertise: Act as the FHIR and CQL subject matter expert, developing and validating CQL logic for digital quality measures while guiding adoption of relevant FHIR profiles, terminologies, and implementation guides. Interoperability Implementation Guides: Apply HL7 FHIR implementation guides including US Core, QI-Core, and/or DEQM to ensure Cotiviti’s data exchange workflows are standards-compliant and contribute to guide development as needed. Data Integration Leadership: Oversee integration of clinical and claims data using HL7 standards, designing FHIR-based APIs and mappings to support seamless transition from legacy formats to modern digital quality reporting. Stakeholder Collaboration: Work closely with technical and non-technical stakeholders to understand their data exchange needs and ensure our interoperability solutions meet real-world workflows. Technical Mentorship and Leadership: Provide technical guidance and mentorship to engineering teams implementing FHIR and CQL solutions. Set coding and integration best practices for handling FHIR resources and APIs. Conduct design and code reviews for FHIR/CQL-related development to ensure quality, performance, and security. Design and develop robust, scalable .NET web APIs to support FHIR-based interoperability, ensuring high performance, maintainability, security and seamless integration with healthcare data systems. Complete all responsibilities as outlined in the annual performance review and/or goal setting. Complete all special projects and other duties as assigned. Must be able to perform duties with or without reasonable accommodation. This job description is intended to describe the general nature and level of work being performed and is not to be construed as an exhaustive list of responsibilities, duties and skills required. This job description does not constitute an employment agreement and is subject to change as the needs of Cotiviti and requirements of the job change. Qualifications Education & Experience: Bachelor’s or advanced degree in computer science, health informatics, or related field. 10+ years of experience in healthcare IT, including substantial hands-on work in interoperability/integration. 5+ years of deep experience with HL7 FHIR (FHIR R4 or later) and related healthcare data standards. FHIR & CQL Mastery: Expert-level knowledge of the FHIR standard (resources, profiles, RESTful API, etc.) and the Clinical Quality Language. Comfortable reading and authoring CQL logic for clinical quality measures. Experience using or implementing a CQL execution engine. Quality Measures & Standards: Understanding of healthcare quality measurement programs and standards. Knowledge of NCQA HEDIS® measures and the transition from traditional reporting to digital quality measures (dQMs). Interoperability Implementation Guides: Demonstrated experience with or strong knowledge of relevant FHIR Implementation Guides and exchange frameworks. This includes US Core profiles (the U.S. baseline FHIR profiles for EHR data), QI-Core (FHIR profiles for quality improvement), and others like FHIR Bulk Data and Carin Blue Button for payer data. Technical Skills: Strong architecture and software engineering skills related to data exchange. Proficiency in designing and consuming RESTful APIs in .NET, C# and working with JSON/XML healthcare data. Experience with FHIR client/server implementations or FHIR data stores. Understanding of healthcare data security and consent, including OAuth2/OpenID Connect for API security and HIPAA compliance considerations. Hands-on ability with query languages or data processing (SQL, etc.). Soft Skills: Excellent communication and stakeholder management abilities. Proven ability to work cross-functionally – collaborating with product managers, clients, clinicians, and engineers. Able to translate regulatory/clinical requirements into technical solutions and explain technical concepts to non-technical audiences. Strong problem-solving mindset and a track record of driving initiatives from concept to implementation. Experience in an Agile development environment, with skills in breaking down complex projects and prioritizing requirements. Leadership and mentorship capabilities are essential – this role will guide teams and represent Cotiviti’s interoperability expertise both internally and externally, so the candidate should be comfortable taking initiative, “leading without authority” when required, and mentoring others. Preferred Qualifications: Prior experience working with quality measurement or population health data is highly desirable. Familiarity with FHIR data models and how they represent clinical concepts for quality measurement. Any experience with cloud-based health data services (AWS, GCP, or Azure healthcare APIs) is a plus. Advanced FHIR Engagement: Participation in HL7 FHIR community activities (e.g., HL7 workgroups, FHIR Connectathons, Da Vinci Project workgroups). Any HL7 or NCQA certifications, such as HL7 FHIR Proficiency/Certification or NCQA’s Digital Quality perspectives, would be a strong plus. Direct involvement in developing or testing digital quality measures or interoperability solutions. Software & Tools: Experience with tools used in quality measurement or health data integration, such as measure authoring/testing tools (CMS MADiE ), clinical data integration engines, or analytics platforms. Familiarity with data warehousing or big data processing of healthcare information (e.g., using Spark or Hadoop for large EHR data sets) is a plus. Any prior work with AI/ML in healthcare data. Domain Expertise: Working knowledge of HEDIS is a plus. Cognitive / Mental Requirements: Excellent communication and stakeholder management abilities. Able to translate regulatory/clinical requirements into technical solutions and explain technical concepts to non-technical audiences. Strong problem-solving mindset and a track record of driving initiatives from concept to implementation. Leadership and mentorship capabilities are essential – this role will guide teams and represent Cotiviti’s interoperability expertise both internally and externally, so the candidate should be comfortable taking initiative, “leading without authority” when required, and mentoring others. Physical Requirements and Working Conditions: Remaining in a stationary position, often standing or sitting for prolonged periods. Repeating motions that may include the wrists, hands and/or fingers. Must be able to provide a dedicated, secure work area. Must be able to provide high-speed internet access / connectivity and office setup and maintenance. Base compensation ranges from $140,000 to $165,000 per year. Specific offers are determined by various factors, such as experience, education, skills, certifications, and other business needs. This role is eligible for discretionary bonus consideration. Cotiviti offers team members a competitive benefits package to address a wide range of personal and family needs, including medical, dental, vision, disability, and life insurance coverage, 401(k) savings plans, paid family leave, 9 paid holidays per year, and 17-27 days of Paid Time Off (PTO) per year, depending on specific level and length of service with Cotiviti. For information about our benefits package, please refer to our Careers page. This role is based remotely and all interviews will be conducted virtually. Date of posting: 10/09/2025 Applications are assessed on a rolling basis. We anticipate that the application window will close on 01/08/2025, but the application window may change depending on the volume of applications received or close immediately if a qualified candidate is selected. #LI-REMOTE #LI-RA1