Senior Integration Engineer

Rockstar is recruiting for a well-funded, early-stage healthcare technology company that supports nurse-practitioner-led independent practices. The client is led by seasoned entrepreneurs and nurse practitioners and backed by investors including Lerer Hippeau and Kairos. Its network of 100+ practices covers 400,000 annual visits and has driven a 30% increase in preventative visits and a 35% drop in hospitalizations.

Location: Hybrid in New York City

Compensation: $160,000 - $195,000 depending on experience, plus equity

About the Client

The client is proving that nurse-practitioner-led care is not just more accessible, it is better. The client helps NPs build and scale independent practices in communities too often overlooked by the health system: rural towns, immigrant populations, LGBTQ+ patients, and more. Backed by AI-driven tools that give independent NPs the backing of a much bigger system, the client's network of 100+ practices covering 400,000 annual visits has driven a 30% increase in preventative visits and a 35% drop in hospitalizations, the clearest sign yet that localized NP-led care means better outcomes.

The client is a well-funded, early-stage company led by seasoned entrepreneurs and nurse practitioners, and backed by investors including Lerer Hippeau and Kairos.

Why This Client, Why Now

Independent primary care is disappearing, swallowed by hospital systems and private equity roll-ups, often pulling out of the communities that need it most. But 31 states now support autonomous NP practice, and the results back up what the client has long believed. The client built the first value-based care contracts for NPs with major payors, taking on real financial risk for outcomes. In the client's anchor market in New Hampshire, the client's network outperformed the state on total cost of care by 19%, proof that a solo NP in an underserved area can outperform a system ten times their size and get rewarded for it.

About the Role

As the Senior Integration Engineer, the candidate will own the pipelines that power the client's platform. The client's integrations touch EHRs across the ambulatory space (Athenahealth, eClinicalWorks, Elation) as well as clearinghouses and data warehouses, and they need to be reliable, observable, and extensible as the client scales.

This is a highly technical IC role that sits at the intersection of integration engineering and product. The Senior Integration Engineer will build new connections from scratch, harden the reliability of existing ones, and work closely with product and engineering to ensure the data flowing through the platform is timely, accurate, and usable. The Senior Integration Engineer will share on-call responsibilities for integration reliability with the broader team.

The Senior Integration Engineer is not just a connector of systems; they are a builder who understands how data quality and pipeline reliability translate directly into practice outcomes and revenue.

What the Senior Integration Engineer Will Do

• Builds new EHR and clearinghouse integrations: Designs and implements integrations with ambulatory EHRs (Athenahealth, eClinicalWorks, Elation) and clearinghouses, using FHIR, HL7v2, and EDI standards. Understands the quirks of each vendor and builds integrations that handle real-world messiness gracefully.
• Owns integration reliability: Hardens existing connections with observability, alerting, and automated failure recovery. Participates in shared on-call for integration incidents and builds the tooling that makes incident response faster and root-cause analysis clearer.
• Builds the data pipelines that power the platform: Designs and maintains the pipelines that ingest, transform, and deliver clinical, scheduling, billing, and claims data from source systems into the platform and data warehouse. Thinks carefully about latency, correctness, and schema evolution.
• Partners with product on data-driven features: Works closely with the product and engineering team to understand what data is needed to power customer-facing features, and ensures the right data arrives in the right shape at the right time. Pushes back when upstream data quality makes a feature untrustworthy.
• Sets the standards for how the client does integration: As the first dedicated integration engineer, defines how the client approaches connection design, error handling, retries, and monitoring. Documents decisions and builds systems that future engineers can extend without fear.

What the Client Is Looking For

• 5+ years of experience as an integration engineer, software engineer, or related discipline
• Strong Python programming skills; comfort reading and writing production-grade backend code
• Experience building and operating production data pipelines, including monitoring, alerting, and incident response
• A builder's orientation: the candidate has worked in small teams where they had to figure things out from scratch, own decisions end-to-end, and move without a lot of process
• Strong communication skills; the candidate can explain a complex integration failure to a non-technical operator as clearly as they can to an engineer

Nice to Have

• Strong command of healthcare interoperability standards: FHIR, HL7v2, and X12 EDI
• Clearinghouse or EDI experience (X12 835/837 claim submission and remittance workflows)
• Experience with cloud data warehouses (BigQuery, Snowflake, or similar)
• Cloud infrastructure experience (AWS or GCP)
• Prior experience at a healthcare tech, RCM, or practice management company
• Familiarity with SMART on FHIR or OAuth-based EHR app frameworks

Benefits

The client also offers equity, competitive benefits, and a hybrid work environment in New York City.

Candidates who are excited about this role are encouraged to apply even if they do not meet every requirement listed. The client cares more about the candidate's ability to build and operate complex systems in ambiguous environments than any single line on their resume.