Senior Backend / Infrastructure Engineer

Role overview

Senior Backend / Infrastructure Engineer responsible for Revelation Pharma’s FHIR R4 data layer and AWS health services stack. This role is the internal technical authority for the HealthLake architecture that downstream agents, frontends, and integrations depend on, with strict HIPAA compliance for all PHI.

Responsibilities

• Own FHIR R4 data model design, including:
  • Resource profiling, extensions, search parameters
  • Terminology bindings for the GLP-1 clinical domain
• Architect and implement the HealthLake data layer:
  • Ingest pipelines
  • FHIR API configuration
  • Query optimization
• Lead the Supabase-to-HealthLake migration:
  • Map 100+ table schema to FHIR resources
  • Handle normalization (free-text drug fields, lab values)
  • Ensure zero data loss during transition
• Design and enforce encryption and PHI access controls:
  • At rest, in transit, and required field-level encryption
  • PHI access control policies across data stores
• Review/approve KMS infrastructure work:
  • Serve as authority for AWS service configuration and IAM policies
  • Review Terraform/CDK infrastructure code
• Build the data access layer consumed by agents and the Canvas frontend (Clinical Protocol, Pharmacy Fulfillment)
• Implement HIPAA-compliant audit logging infrastructure that replaces manual archiving patterns
• Configure AWS Clean Rooms for de-identified analytics use cases

Required qualifications

• 7+ years backend engineering; 3+ years focused on healthcare data infrastructure or interoperability
• Deep FHIR R4 expertise:
  • Designed FHIR resource profiles
  • Implemented FHIR servers and/or worked extensively with FHIR APIs
  • Strong understanding of profiling decisions that avoid technical debt
• Strong AWS experience, specifically:
  • HealthLake, Lambda, Step Functions, DynamoDB, S3, IAM, KMS
  • Comfortable owning production AWS infrastructure in a HIPAA-regulated environment
• Production experience migrating data from non-FHIR systems to FHIR:
  • Schema mapping, terminology normalization, and data validation pipelines
• Deep understanding of HIPAA technical safeguards:
  • Encryption, access controls, audit logging
  • Minimum necessary and BAA implications for service selection
• Strong SQL and API design skills; ability to work with relational and document-oriented patterns
• Experience overseeing outsourced development teams via review/oversight

Preferred qualifications

• Pharmacy data standards and medication-related FHIR resources (NCPDP, RxNorm, NDC; MedicationRequest/Dispense/Knowledge)
• Familiarity with AWS Clean Rooms and healthcare analytics queries (e.g., Athena)
• Experience with Bedrock or other LLM platforms for retrieval/data access (RAG, vector search)
• Prior work with Supabase and/or PostgreSQL in healthcare contexts
• Exposure to SMART on FHIR, CDS Hooks, or other clinical decision support integration patterns