Senior FHIR Interoperability Consultant with CMS

Senior FHIR Interoperability Consultant

Location: Hartford, CT 6103: Onsite Visa: GC AND USC ONLY F2F Interview(YES)

Must Have Skills:

• Strong expertise in HL7 FHIR standards.
• Ability to analyze and interpret key FHIR Implementation Guides including CARIN BB, US Core, Da Vinci PDEX, Da Vinci CRD, DTR, and PAS.
• Deep understanding of CMS 9115 (Patient Access API) and CMS‑0057‑F Interoperability & Prior Authorization regulations.
• Experience in FHIR API design, data modeling, and interoperability workflows.
• Familiarity with HIPAA and healthcare data privacy/security regulations.
• Knowledge of related healthcare data standards such as HL7 v2, CCDA, USCDI, SNOMED, LOINC, and CPT.
• Ability to create comprehensive technical documentation, including data mappings, data flow diagrams, API specifications, and test cases.
• Strong analytical, problemsolving, and communication skills.
• Experience working within Agile/Scrum development environments.
• Experience in the payer domain (claims, benefits, prior authorization workflows).
• Experience with AWS or Azure cloud environments.
• Experience working with EHR systems and EMR integrations.

Detailed Job Description:

• The project focuses on implementing CMS-required FHIR interoperability and prior authorization solutions aligned with CMS 9115 and CMS‑0057‑F regulations.
• The FHIR Consultant will translate regulatory and FHIR Implementation Guide requirements—such as CARIN BB, US Core, and Da Vinci PDEX, CRD, DTR, and PAS—into technical specifications that support compliant API development.
• The role involves guiding architecture, data modeling, documentation, and integration activities across payer systems and EMRs.
• Working closely with product, engineering, and business teams in an Agile environment, the consultant will help deliver secure, scalable, and future-ready interoperability capabilities for improved member and provider experiences.