M&S (which stands for Management and Solutions) was conceived in 2002 with the vision of creating highly effective teams of elite consultants to deliver strategic process and technology solutions to enterprise organizations across the US. Our commitment to delivery in complex environments and long-term customer success has merged process and technology into innovative solutions, established deep pockets of expertise, and enabled innovative transformation for evolving businesses.

We have intentionally cultivated steady growth focused on being approachable and helpful to our dearly valued clients and closely cared-for employees. M&S people simply “care hard”, and this reflects in our work products, our interactions, and our culture.

The work

Client is standing up a FHIR Hub that Medicare Administrative Contractors are expected to consume. The client owns everything on their side of that boundary: registering as a client of the Hub, consuming its interfaces, and landing the resulting data in their core platforms.

You will be an engineer building that pipeline end to end. In practice it has four stages:

1. Authenticate and consume the client Hub — establish the client registration (keypair, JWKS or registered public key, assigned scopes, sandbox credentials, connectivity testing), then build the .NET services that call the interfaces and handle short-lived access tokens.
2. Land the data — persist to a database with staging, checkpointing, and an audit trail of what was retrieved and when.
3. Deliver to downstream systems — transform the API JSON into the formats those systems accept, including fixed-width or delimited .dat and .xml documents, dropped for pickup.
4. Scan before delivery — route generated documents through virus scanning, with defined quarantine and failure handling.

The ingestion must be idempotent, re-startable, monitored and documented — built for ongoing operation, not a one-off load. You will hand over a runbook to the client's operations team.

What you will do:

• Build .NET services that consume authenticated REST/FHIR interfaces, handling paging, throttling, retries, token refresh, and partial failure.
• Implement bulk export handling if the Hub follows the clients bulk data pattern — asynchronous kick-off, manifest polling, NDJSON streaming, resumable download.
• Map source resources to the client's target data models, working directly with the client SMEs who own them.
• Design the JSON-to-file transformation: record layouts, field padding and justification, encoding, headers and trailers, control counts, file naming and sequencing.
• Produce XML that validates against a supplied schema, and fixed-width output a legacy consumer accepts without hand-holding.
• Build idempotent load, reconciliation counts agreed with data owners, and error handling that makes failures visible and recoverable.
• Integrate antivirus scanning into the delivery path and implement quarantine/failure routing.
• Deliver files over secure transport with atomic write semantics, so a consumer never picks up a half-written file.
• Write the integration design up front, and the runbook at the end. Submit weekly written progress reports.

Required Skills:

• Strong C# / .NET — production services or scheduled jobs, not only web APIs.
• REST/JSON integration — consuming third-party APIs with OAuth 2.0 or token-based auth.
• File-format engineering — demonstrable experience producing fixed-width or delimited flat files and/or XML validated against an XSD for another system to consume. Please bring a specific example.
• SQL and relational data modeling — staging, transactions, set-based work.
• Batch/job orchestration — Windows Services, scheduled tasks, Quartz, Hangfire or equivalent, with restartability and idempotency.
• Secure file transfer — SFTP or equivalent, and an understanding of atomic delivery.
• Clear written communication. You will extract undocumented requirements from client SMEs and write them down.

Preferred Skills:

• FHIR R4 and US Core, and the SMART Backend Services authorization pattern (OAuth 2.0 client credentials with a signed JWT assertion). Genuinely useful here — but see below.
• Healthcare payer or Medicare experience — Medicare Administrative Contractor systems, claims processing, EDI X12 (837/835).
• Antivirus/content-scanning integration — ICAP, ClamAV, Trellix/McAfee, or similar invoked from an application pipeline.
• Firely SDK (Hl7.Fhir.R4) for .NET.
• Federal security and compliance exposure — FISMA, MARS-E, or work inside a client ATO boundary.

A note on FHIR:

The posting says FHIR, and FHIR knowledge helps. But the depth of this build is on the transformation and delivery side: getting data out of an API is a week of ramp, getting it into a legacy consumer's exact expected format is the engagement.

A strong .NET integration engineer who has never touched FHIR is a better fit here than a FHIR specialist who has never produced a fixed-width file. Apply on the strength of your integration work.

The Following Are Contractual Requirements:

• US residency for at least 3 of the last 5 years.
• Background check required.
• All work performed inside the continental United States.

*M&S Consulting proactively fulfills its role as an equal opportunity employer. We do not discriminate against any employee or applicant for employment because of race, color, sex, religion, age, sexual orientation, gender identity and expression, national origin, marital status, physical or mental disability, status as a protected veteran, or any other characteristic protected by law.