Overview

Company: Metric Tree Labs (dedicated engagement with a US healthcare client)

Responsibilities

• Build EHR integrations. Connect to Epic, Oracle Health (Cerner), eClinicalWorks, athenahealth and OncoEMR using FHIR R4 and SMART on FHIR. This covers:
• OAuth flows and token refresh
• patient data retrieval and bulk exports
• recurring synchronization
• Build reliable data pipelines. Write ingestion workers that handle:
• pagination and API rate limits
• retries and checkpoints
• duplicate records and partial failures
• Model clinical data. Normalize patients, conditions, medications and other FHIR resources into PostgreSQL, preserving source evidence and clinical context.
• Ship product features. Build clean, usable Next.js/React interfaces for patient records, eligibility review, screening and trial workflows.
• Extend AI workflows. Work on document parsing, criteria extraction, patient matching, and AI-assisted SMS/voice screening using LLM APIs.
• Build secure backend APIs. Deliver REST APIs, webhooks, role-based permissions and audit trails that handle sensitive patient data correctly.
• Own delivery. Write tests, review code, document decisions, deploy on AWS, monitor production and fix issues.

Qualifications

• own features end to end, from design discussions through production deployment
• grow with the product
• 6-8 years building and running production web applications, with clear examples of features or services you personally owned end to end.
• Strong TypeScript/Node.js backend skills. NestJS or Express is a plus.
• Hands-on React and Next.js, with the ability to build a clean, functional dashboard quickly.
• Solid experience consuming third-party REST APIs, including:
• OAuth 2.0 authentication
• cursor/link-based pagination
• handling 429s and rate limits
• retries with backoff
• error handling
• Strong PostgreSQL skills: data modeling, migrations, indexing, and idempotent upserts so that re-running a sync never creates duplicates.
• Comfort deploying on AWS and Vercel, and working with Docker.
• Ability to pick up unfamiliar APIs and vendor documentation fast, and to work independently.
• Clear written communication. You should be able to explain your approach, trade-offs and design decisions in a README or design note.
• Hands-on FHIR R4 experience: Patient, Condition, MedicationRequest and related resources, Bundles, search parameters and _lastUpdated-based incremental sync.
• SMART on FHIR authorization, including standalone launch, backend services and JWT client assertions.
• Strongly Preferred
• Familiarity with FHIR Bulk Data ($export) and HL7 v2.
• Exposure to Drizzle/Prisma, AWS CDK, SQS/ECS, Twilio or ElevenLabs.
• Profile screening
• Technical discussion with MTL
• A practical take-home assignment involving real healthcare API integration, submitted as a deployed app, a repo and a README
• A final interview with the client's founder
• Work directly with a US founder and a small, sharp engineering team.
• Take real ownership across a live healthcare product, EHR integrations and applied AI.