Interoperability & Standards Specialist (US)

Position details

About the role

Very few people get to see both how US interoperability regulation is written and how it plays out inside a working FHIR product. In this role, you’ll become one of them, and grow expertise that’s genuinely rare and valuable.

Firely builds FHIR-based interoperability software. Firely Server is ONC-certified health IT, and our digital quality measure pipeline is NCQA HEDIS certified. These certifications are commitments to our customers, and keeping them current is meaningful work with real deadlines. Much of our US business serves the payer market, where CMS rules such as the Interoperability and Prior Authorization Final Rule (CMS-0057-F) directly shape what our products must do.

That’s where you come in. You’ll own Firely’s US certifications end to end, keep us connected to the standards communities that shape our products, and act as our early-warning system for everything CMS, ASTP/ONC and NCQA publish. It’s a hands-on role: you’ll personally prepare and submit the quarterly certification packages, run measure test decks through our pipeline, and write the summaries the product team relies on.

You’ll be part of the Product team and work closely with Alexander Zautke, our VP of Product & Standards. Alexander sets the direction on regulatory and standards strategy and decides what lands on the roadmap. You’ll drive the execution, dig into the details, and bring back the analysis our decisions are built on. We’re looking for someone self-sufficient who brings ideas and solutions forward on their own. Over time, you’ll take on more of the analysis and the calls yourself.

This is an engineering-minded role, not a pure compliance one, so you don’t need to be a regulatory expert. What matters most is strong hands-on experience with interoperability and the US healthcare system, and real curiosity about the regulatory landscape around it.

Your core responsibility: certification

• ONC/ASTP certification maintenance. Prepare and submit the quarterly (g)(10) maintenance package to Drummond, our ONC-ACB: summary of changes, Inferno test results and the required attestation forms. File SVAP submissions when we adopt a new standards version, and complete the bi-annual attestations in CHPL.
• Real World Testing. Write the annual RWT plan and results report, and run the testing behind them. RWT is currently under a moratorium; you'll pick it up when it restarts.
• NCQA HEDIS measure certification. For each measure, pull the test decks, run them through Firely Server and our dQM pipeline, review the output, submit to NCQA and work the tickets until the measure passes. As Firely's day-to-day contact with NCQA, you keep the correspondence off our engineers' plates so they can focus on fixing what you find.
• Certified version transitions. When a major Firely Server version ships, analyze the release notes against the (g)(10) criteria, work with Drummond to move the certification, and file the withdrawal request for the retired version.
• Organizational obligations. Track the non-product (g)(10) requirements (Information Blocking, Assurances, Communications), keep our public certification disclosures accurate, and flag gaps early. Accountability sits with the VP of Product & Standards; you make sure nothing is missed.

Regulatory monitoring

You make sure nothing relevant gets past us, and that what does arrives in a form the product team can act on. You and the VP of Product & Standards agree which areas to watch closely.

• Weekly scan. Work through the Federal Register, CMS, ASTP/ONC and NCQA for proposed and final rules, RFIs and RFCs. Screen them against the topics that matter to us: FHIR, digital quality measures, USCDI, prior authorization, payer APIs.
• Written analysis. For every relevant rule, write a summary: what it requires, what it means for our products and customers, and what you recommend. Write it even when the answer is "no action needed"; that conclusion is worth recording. Where a rule needs more, you work with the VP of Product & Standards on a deeper analysis.
• Analysis into work. Translate product impact into Confluence pages and Jira tickets that engineering can pick up.
• Regulatory tracker. Keep it current so anyone at Firely can see what is coming and when.
• Comment letters. Track deadlines, gather input from across Firely, draft our responses to CMS and ONC, get sign-off and submit on regulations.gov.
• Stay current. Attend ONC roundtables, CMS seminars and similar sessions.

Standards community work

Firely helps build the standards we implement. We are active in DQIC (the technical workgroup, plus its CQL unit testing and tooling subgroups), the HL7 Da Vinci Project, the HL7 FHIR Quality Accelerator, the HL7 CQI Workgroup, HL7 Connectathons on the DQM track, and ONC community forums. You manage Firely's communication and work items across these groups, and report back on any action we need to take to stay compliant and competitive.

• Prepare. Pull together background on agenda items and ballot topics, summarize where things stand, and get our position ready so the VP of Product & Standards walks in briefed.
• Follow up. Track what was decided, turn outcomes into Confluence pages and Jira tickets, and chase the items that belong to us.
• Connectathon groundwork. Set up the test environment, prepare our FHIR server and DQM test tooling, work through PR testing, pass validation issues to engineering and write up the results.
• Administration. Register Firely's US members for Connectathons and Working Group Meetings, track ballot and comment deadlines, and keep our participation in good order.

You'll join meetings yourself where it helps, some regularly and some occasionally; which one is a conversation with the VP of Product & Standards. As you build standing in these communities, you take on more of the representation directly. That is a growth path, not a starting requirement.

Also part of the role: prototyping and technical writing

Alongside the core work, you'll contribute in two further areas.

• Prototypes. Help the VP of Product & Standards build prototypes that test ideas for Firely Server's product strategy. Your fluency with interoperability standards, combined with AI tools, helps us explore those ideas quickly.
• Technical writing. Contribute internal memos on our certifications and help keep technical documentation up to date.

Who you are

We expect roughly 3–5 years of relevant experience, but we care more about the combination of interoperability and US healthcare experience than the years.

• You're comfortable with the technology. You can run software yourself, read logs and test output, and work out why something failed before asking someone else. You don't need to write production code, but you can read a FHIR resource, follow a validation error, and work with APIs and test tooling without hand-holding. Experience with CQL is a real advantage.
• You can read regulation and say what it means, or you're keen to learn. You can work through a 300-page proposed rule and come back with two paragraphs on what actually matters to us. You're comfortable saying "this one doesn't affect us" when that's the answer.
• You connect the two. The value of this role is the link between a regulatory requirement and what our product does. You enjoy sitting in that gap.
• You write clearly. Memos, analyses, documentation and comment letters are a core part of the job.
• You own your deadlines. Certification runs on fixed dates that don't move, and you keep track of them without being reminded.
• You're self-sufficient and work well with senior stakeholders. You take direction and context from the VP of Product & Standards and come back with work that's done, not work that needs redoing. You ask when you're stuck and push back when something doesn't add up.
• You're curious about AI. Firely embraces AI. We want you to explore and get creative with how it can make our work faster without making it worse, and how it can shape our products and what we offer clients.
• You're based in the US and understand the US healthcare market, ideally including payers.

Bonus points

None of these are required, but any one of them will make your application stand out.

• Hands-on experience with ONC/ASTP certification: Inferno, CHPL, SVAP, Real World Testing, or working with an ACB such as Drummond
• Experience with NCQA HEDIS measure certification or digital quality measures
• Working knowledge of CQL
• Experience with CMS payer interoperability requirements, such as CMS-0057-F
• Experience at a certified health IT vendor, an EHR company or a health plan
• Existing participation in HL7, Da Vinci, DQIC or similar
• Experience drafting or coordinating formal regulatory comment letters

If you're technical and want to move into regulatory work, this role is built for you. If you know the regulatory side well but have less hands-on FHIR experience, tell us too.

How you'll grow

There is real room to grow here. We would rather grow you into more than hire over you.

You start by executing the certification work and doing the first pass on regulatory analysis, with the VP of Product & Standards setting priorities and reviewing your conclusions. As your judgement builds, you take more of the calls yourself: which rules matter, what we should recommend, and where we should push back. Over time you take on the outward-facing work too, presenting in workgroups, contributing to our comment letters and briefing customers on what's coming.

Benefits we offer

• Fully remote working environment
• 401(k), health and medical benefits, life and disability insurance
• 22 vacation days
• Annual learning & development budget
• Home office budget

Practicalities

• Location: Remote within the US.
• Working with a Dutch team: Firely is headquartered in Amsterdam, and our product and engineering teams are largely in Europe, so expect some early-morning overlap. In exchange, your afternoons are quieter and allow for focus time or US team collaboration.
• Travel: Around 4–5 week-long trips a year for Connectathons, HL7 Working Group Meetings and industry events. Plus,annual trips to Amsterdam for team building during our International Week!
• Your Team Lead: You report to Alexander Zautke, VP of Product & Standards, and sit in the Product team.
• Salary: $90,000-$110,000 annual base salary.