API Integration Engineer

Company Description

SataGroup is a GovTech company specializing in AI-driven solutions, digital transformation, and technology services for government agencies and public sector organizations. We support clients through innovative products and specialized services, including web and application development, workforce solutions, and enterprise modernization initiatives. Our focus is on helping organizations build scalable, secure, and high-performing digital systems that improve operational efficiency and support mission-critical objectives.

Position Overview

• Duration: 12 months with up to 2 one-year renewal options
• Location: Pierre, SD (Quarterly on-site, remainder remote)
• Visa Status: Must be a Citizen in USA or Green Card
• Engagement Type: Contract W2
• Rate: $60/W2

Position Summary

We are seeking a qualified vendor or individual with deep expertise in healthcare interoperability to implement and support compliance with the CMS Interoperability and Patient Access Final Rule (CMS-9115-F) and the 2024 CMS Interoperability and Prior Authorization Final Rule (CMS-0057-F). The selected candidate will design, deploy, and sustain FHIR-based APIs that enable Medicaid members to securely share their health information with third-party applications.

Key Responsibilities

1. Patient Access API

• Implement and maintain a CMS-9115-F-compliant Patient Access API using FHIR R4 (v4.0.1+).
• Host a cloud-based FHIR API server with a façade data model serving claims, encounters, clinical (USCD1 v1+), and drug formulary data.
• Ensure data availability within required timeframes: claims/encounters/clinical data within 1 business day; drug formularies within 30 calendar days; drug benefit data within 1 business day of effective date.
• Maintain 99.9% system availability and provide fully documented APIs and operations plans.
• Support data for recipients with dates of service on or after January 1, 2016 who are active members.

2. Provider Access API

• Implement and maintain a CMS-0057-F-compliant Provider Access API on a cloud-hosted FHIR R4 server.
• Expose claims, encounters, and clinical data (USCD1 v1+) using implementation guides (CARIN IG, US Core IG, Da Vinci IG).
• Ensure data availability within 1 business day of receipt; maintain 99.9% uptime.

3. Payer- to Payer API

• Implement a Payer-to-Payer API compliant with CMS-0057-F on a cloud-hosted FHIR R4 server.
• Share patient data with a date of service within five years of the data request.
• Provide fully documented API and documented maintenance/operations plan with 99.9% availability.

4. Consent & Identity Management

• Build and manage member consent workflows for SMART on FHIR third-party applications, enabling members to view, track, and modify consent.
• Integrate with the existing Medical Services portal and data warehouse.
• Support identity verification and authentication via OAuth 2.0+ and OpenID Connect 1.0+ (including errata set 1).
• Implement SMART on FHIR authorization (Application Launch Framework IG Release 1.0.0) for secure API access.
• Provide customer service support for member inquiries and troubleshooting.

5. Third-Party Application Support

• Establish a registration and onboarding process for third-party SMART on FHIR applications.
• Create and maintain publicly accessible API documentation.
• Implement a third-party attestation process covering application privacy policy disclosures to members.
• Conduct security risk assessments for third-party applications seeking API access.
• Enable Medical Services administrators to revoke or discontinue API access.
• Operate a developer portal or sandbox for third-party developers to test with sample data.
• Provide customer service for third-party developer questions and troubleshooting.

6. Technical Support & Training

• Deliver initial and ongoing training for DSS staff, including during implementation and staff transitions.
• Offer technical support and training for platform modules and user provisioning.
• Provide self-service training materials (e.g., PowerPoint slides, recorded webinars) covering core functionality and reporting.

7. System Maintenance & Operations

• Take responsibility for ongoing system maintenance throughout the contract term.
• Implement software improvements as needed to maintain compliance with federal and state regulations.
• Deliver incident and error reporting for the system.
• Provide a test/staging environment for DMS staff to validate enhancements before production release.

8. Account Management

• Designate a primary point of contact for day-to-day operations, issue escalation, and resolution.
• Work closely with DSS and Medical Services staff to align the solution with departmental workflows.
• Maintain a log of enhancements and issue resolutions for prioritization purposes.

9. Implementation Services

• Collaborate with DSS to prepare a project plan, schedule, and requirement traceability matrix (RTM).
• Develop business, reporting, and technical requirements in partnership with DSS.
• Establish connectivity, develop a test plan, and execute system/integration testing including UAT prior to go-live.
• Assign a dedicated project manager to manage risks, issues, communication plans, meeting minutes, and change control throughout the project lifecycle.

Required Qualifications & Skills

Technical Expertise

• Demonstrated expertise implementing CMS Interoperability Final Rules (CMS-9115-F and/or CMS-0057-F).
• Deep knowledge of FHIR R4 (v4.0.1+) and related implementation guides: CARIN IG for Blue Button, US Core IG, Da Vinci IG.
• Proficiency with SMART on FHIR authorization, OAuth 2.0, and OpenID Connect.
• Experience building and operating cloud-hosted FHIR API servers at scale (99.9%+ SLA).
• Familiarity with Medicaid/Medicare data types: claims, encounters, clinical records, drug formularies.

Project & Program Management

• Proven ability to deliver complex healthcare IT projects on time and within scope.
• Experience managing Requirement Traceability Matrices (RTMs), project plans, and UAT processes.
• Strong communication and stakeholder management skills, particularly with government agencies.

Preferred Experience

• Prior work with state Medicaid agencies or health plans.
• Experience managing developer portals, third-party application onboarding, and security risk assessments.
• Familiarity with South Dakota DSS systems or similar state health information technology environments.