Staff Engineer - FHIR Server Platform

Staff Engineer, FHIR Platform
Individual Contributor · Remote (US) · Full-Time

Company Overview

b.well is transforming the healthcare experience by empowering individuals to access and act on their complete health record. We unify data across health systems, payers, labs, pharmacies, and wearable devices using modern APIs and interoperability standards (FHIR, HL7, CCDA), helping people make better health decisions for themselves and their families.

Our platform is already driving impact at scale, with integrations that include Walgreens (100M+ users) and Samsung Health (60M+ users). We partner with health systems, payers, employers, and platform partners to deliver a deeply personalized and actionable health experience. Join us as we modernize one of the most complex, fragmented, and mission-critical industries in the world.

The Role

Everything b.well builds sits on top of one system: our FHIR server — the system of record for every consumer's longitudinal health record. It's multi-tenant, handles very high write and read volumes, and powers the search, aggregation, and data-export operations behind our apps, our AI experiences, and our partners' integrations.

We're hiring a Staff Engineer to be the technical owner of this platform: its architecture, performance, cost, and security model. You'll drive down infrastructure cost and latency at scale, build consent-based access controls into the platform, close out FHIR standards-conformance gaps, and make the platform easier for every other engineering team to build on.

This is a hands-on, high-ownership role for someone who has run a high-throughput, PHI-carrying data platform before and treats correctness, tenant isolation, and cost as engineering problems with numbers attached. You'll pair deep distributed-systems and FHIR fluency with modern AI-native tooling to move faster without cutting corners.

What You'll Do

Own the Platform End to End

• Serve as the technical owner for the FHIR server platform — architecture, roadmap, production health, and cost — from design review through incident response.
• Drive down write/read latency and infrastructure cost through better indexing, caching, storage tiering, and service decomposition.
• Own observability, capacity planning, and the reliability bar for a platform our products depend on every day.

Build Security & Compliance Into the Platform

• Implement consent-based, resource-level access control and sensitive-data filtering directly on the FHIR server.
• Own the platform's security and multi-tenant data-isolation model.
• Deliver data-governance capabilities (e.g., data deletion on request) and keep the platform aligned with HIPAA, the 21st Century Cures Act, and CMS interoperability rules.

Drive FHIR Conformance

• Close remaining gaps to full FHIR R4/R4B conformance across our resource library.
• Support the standards work behind our participation in CMS's health-data interoperability initiatives — Patient Access APIs, bulk data, and international patient summaries.

Multiply the Team

• Make the platform easy to build on: clear documentation, error semantics, and self-service debugging so other teams aren't blocked waiting on the FHIR team.
• Mentor engineers through design review, pairing, and code review.
• Represent the platform externally — it's open source — including standards conversations and vendor relationships.

Work AI-Native

• Use coding agents and reusable AI skills as a first-class part of building, testing, and validating platform changes.
• Keep human judgment on anything PHI-adjacent or production-impacting.

Required Experience

Must-Have

• 8+ years in backend/platform engineering, with a track record of owning a high-throughput production API platform at population scale with real-time responses.
• Deep, demonstrable FHIR fluency — ideally from building or operating a FHIR server, not only consuming one.
• Production experience scaling a document or NoSQL database (MongoDB strongly preferred): indexing, sharding, and cost optimization at real scale.
• Distributed-systems judgment: caching strategy, idempotency, event-driven architecture, and decomposing a monolith under load.
• Experience as technical lead/DRI for a platform other teams build on.
• AI-native: you already build with coding agents and reusable AI skills without compromising engineering rigor.

Technical Skills

• Strong Node.js/TypeScript plus at least one other backend language.
• MongoDB at scale: aggregation, indexing, sharding, change streams.
• Kubernetes, event streaming (Kafka or equivalent), infrastructure-as-code.
• API security: OAuth 2.0/OIDC, SMART on FHIR scopes, rate limiting, audit logging.
• Observability and performance engineering at production scale.
• HIPAA-grade, PHI-safe engineering and tenant data isolation.

Preferred

• Experience with other FHIR server implementations.
• US Core/USCDI, IPS, bulk data, and CMS interoperability rule implementation experience.
• Experience offloading hot-store data to analytical storage (e.g., a lakehouse).
• Consent management or record-level access control in a healthcare context.
• Open-source maintenance or public technical presence.
  
  The target salary range for this position is $185,000 - $250,000 and is part of a competitive total rewards package including stock options, benefits, and incentive pay for eligible roles. Individual pay may vary from the target range and is determined by a number of factors including experience, location, internal pay equity, and other relevant business considerations. We review all employee pay and compensation programs annually at minimum to ensure competitive and fair pay.
  
  Data shows that women, people of color, and other underrepresented groups may be less likely to apply for jobs unless they believe they are a perfect match. But b.well holds diversity amongst its key values, and we have a strong commitment to building our workforce and products through that lens.
  
  You don't have to check every box in this job description to be a great fit for the role! If you're excited about this position and the prospect of working for b.well, please apply. If it turns out this role isn't for you, there may be other openings that could align with your experience and expertise!
  
  We are committed to an inclusive and diverse b.well. We are an equal opportunity employer. We do not discriminate based on race, ethnicity, color, ancestry, national origin, religion, sex, sexual orientation, gender identity, age, disability, veteran, genetic information, marital status or any other legally protected status.