Lead Technical Architect

About MedKey

MedKey Health is building a secure interoperability layer that unifies fragmented patient medical records across healthcare systems using standards-based integrations. We are intentionally starting with a FHIR R4 sandbox pilot to validate core infrastructure before scaling to production environments.

We are a founder-led, early stage company prioritizing correctness, auditability, and trust over speed or feature volume.

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Role Overview

We are seeking a Fractional Lead Technical Architect to design and implement MedKey’s initial backend infrastructure. This role is ideal for a senior engineer who enjoys early stage problem solving, architectural ownership, and hands on building — without the pressure of full-time commitment.

You will lead the technical execution of our FHIR sandbox pilot and help define MedKey’s long term platform foundations.

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What You Will Build (Initial Scope)

• Secure authentication to a FHIR R4 sandbox (SMART on FHIR / OAuth 2.0)
• Ingestion of core FHIR resources:
• Patient
• Encounter
• Observation
• MedicationRequest
• Condition
• AllergyIntolerance
• Dual-layer data storage:
• raw source records (immutable)
• normalized MedKey data models
• A unified patient timeline API
• Patient consent and role-based access controls
• Audit logging for data access and ingestion activity
• Baseline security practices (encryption, secrets management, environment separation)

This is a read-only, pilot-focused build. Production integrations, AI, and write-back workflows are explicitly out of scope for this phase.

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Responsibilities

• Design MedKey’s system architecture and data flow
• Lead backend development and integration strategy
• Implement ingestion pipelines and background jobs
• Own data modeling and normalization logic
• Establish consent enforcement and auditability
• Document architectural decisions and pilot scope
• Participate in technical discussions with hospital IT and advisors

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Required Experience

• 6+ years of backend or full-stack engineering experience
• Strong API design and data modeling skills
• Experience implementing OAuth 2.0–based integrations
• Familiarity with healthcare interoperability concepts (FHIR, HL7, CCD, etc.)
• Experience building systems on AWS or comparable cloud platforms
• Security-conscious approach to handling sensitive data

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Nice to Have

• Prior healthtech or regulated-industry experience
• Direct experience with FHIR R4 or SMART on FHIR
• Early-stage startup or greenfield build experience
• Experience designing audit and compliance systems

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Time Commitment & Engagement

• 15–20 hours per week (flexible scheduling)
• Initial engagement of 8–12 weeks, with the potential to expand scope or commitment based on pilot progress

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What Success Looks Like (First 90 Days)

• Working FHIR sandbox integration
• Reliable ingestion of core FHIR resources
• Clear architecture and technical documentation
• Unified patient timeline API
• Pilot-ready backend with audit logging and consent enforcement

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Hiring Timeline

We are intentionally taking a thoughtful approach to this hire. Our goal is to identify and onboard the right technical leader within the next 2–3 months.

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Compensation:

This is a paid, fractional role. Compensation is competitive and commensurate with experience, with an expected range of $75–$120/hour for 15–20 hours per week. Equity participation may be discussed for the right long-term fit.

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How to Apply

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