Job Description

Symmetrio is recruiting a Software Engineer, Healthcare Integrations for our client, a rapidly growing international healthcare technology company building an AI-enabled platform for US and international radiation oncology and clinical care organizations.

The Software Engineer, Healthcare Integrations will build and run the integrations that connect our customer’s platform to the systems US healthcare customers use in production, including Epic, Varian ARIA, Elekta MOSAIQ, iKnowMed and others. The Software Engineer, Healthcare Integrations will build the channels and mappings for each customer, and the agentic integration engine that executes them. Our customer’s team writes and maintains that engine in-house, and you will become an integral part of that team.

The Software Engineer will own customer integrations end to end, from the customer's data model through go-live to production support, working with an international engineering team, Product, Clinical and Customer Success, and directly with hospital IT and vendor interface teams.

Remote (United States – Candidates must be located within the Pacific Time Zone and work Pacific Time business hours) | Full-time | Occasional travel (up to ~10–15%)

Compensation: $140,000 - $185,000 per year

Our customer offers

• 160 hours of vacation, six holidays, and four floating holidays each calendar year (prorated the first year)
• Health and wellness plans, such as medical, dental, vision, basic life, and disability coverage.

Responsibilities

• Build integrations: Design and build HL7, FHIR and SQL integrations with customer EMR and oncology systems, from data-model analysis and mapping specification through testing and go-live.
• Develop the engine: Extend and harden the integration engine (new source kinds, transforms, resilience, observability), shipping production Python through a pull request, review and CI flow.
• Build with and for agents: Use coding agents as a core part of how you ship. Extend the integration agent so more mapping authoring, run diagnosis and customer onboarding happens with an agent in the loop.
• Run production: Operate integrations in an AWS and Kubernetes environment. Monitor, diagnose and fix failures across the full message path, from malformed messages to data-integrity issues.
• Onboard customers: Work directly with hospital and clinic IT teams during onboarding: configuration, joint testing and go-live support.
• Document: Maintain interface specifications, mapping documents and runbooks that the team and customers can rely on after go-live.
• Make the next one faster: Turn each integration into reusable templates, mapping standards and tooling.

Requirements

• 5+ years in healthcare integration, ideally in radiation oncology or imaging.
• 3+ years building and operating backend services in Python or a comparable language, with automated tests, code review and CI. You own a codebase, not just a product's configuration.
• Familiarity with FHIR R4 and HL7 v2.x (ADT, ORU, SIU). Comfortable with REST APIs and SQL against vendor schemas.
• Production experience with at least one of Epic, Varian ARIA or Elekta MOSAIQ, and with an interface engine (Mirth Connect, Rhapsody, Cloverleaf, Corepoint or similar).
• Data mapping across clinical systems: coded values, units and identifiers.
• Working knowledge of AWS and Docker.
• Clear written documentation: specs and runbooks a colleague or customer can follow without you in the room.

Nice to Have

• iKnowMed, Cerner or other oncology and EMR platforms beyond those above.
• Event-driven backends (NATS, Kafka or similar), Postgres and observability tooling.
• DICOM, and how imaging data flows alongside HL7/FHIR in an oncology workflow.
• Kubernetes and Terraform.
• Radiation oncology clinical workflows: how treatment planning and delivery data is used by care teams.
• Fluency with AI coding agents (Claude Code, Cursor or similar) as a daily tool, and curiosity about how far they can go.

Other Requirements

• Ability to work core US business hours, with occasional early or late calls to coordinate with colleagues in other time zones.
• Comfortable handling protected health information (PHI) in compliance with HIPAA and company data-handling policies.
• Willingness to travel occasionally (approximately 10-15%) to customer sites for onboarding and go-live support.

Benefits

• 160 hours of vacation, six holidays, and four floating holidays each calendar year (prorated the first year)
• Health and wellness plans, such as medical, dental, vision, basic life, and disability coverage. You are eligible to participate in these benefits effective the first of the month following your date of hire. You may choose to elect coverage for your family on many of these plans, provided they meet eligibility requirements;
• Retirement/401(k) plan
• Other voluntary programs and opportunities for work/life support.