SENIOR INTEGRATION ENGINEER OVERVIEW Duet empowers Nurse Practitioners to run and grow independent primary care clinics—closing gaps in access while keeping care local and clinician-owned. We're a well-funded seed-stage company backed by Kairos HQ, Lerer Hippeau, and others. Duet is building a vertically integrated enablement platform for NP-led practices: software that reduces administrative overhead, improves cash flow, and gives clinicians the leverage to operate sustainable businesses without corporate consolidation. Everything we build runs on data that moves reliably between EHRs, practice management systems, clearinghouses, and our platform. That infrastructure is the foundation for everything else—and we're looking for someone to own it. ABOUT THE ROLE As our Senior Integration Engineer, you'll own the pipelines that power Duet's platform. Our 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 we scale. This is a highly technical IC role that sits at the intersection of integration engineering and product. You'll build new connections from scratch, harden the reliability of existing ones, and work closely with product and engineering to ensure the data flowing through our platform is timely, accurate, and usable. You'll share on-call responsibilities for integration reliability with the broader team. You're not just a connector of systems—you're a builder who understands how data quality and pipeline reliability translate directly into practice outcomes and revenue. WHAT YOU'LL DO Build new EHR and clearinghouse integrations. Design and implement integrations with ambulatory EHRs (Athenahealth, eClinicalWorks, Elation) and clearinghouses, using FHIR, HL7v2, and EDI standards. Understand the quirks of each vendor and build integrations that handle real-world messiness gracefully. Own integration reliability. Harden existing connections with observability, alerting, and automated failure recovery. Participate in shared on-call for integration incidents and build the tooling that makes incident response faster and root-cause analysis clearer. Build the data pipelines that power our platform. Design and maintain the pipelines that ingest, transform, and deliver clinical, scheduling, billing, and claims data from source systems into our platform and data warehouse. Think carefully about latency, correctness, and schema evolution. Partner with product on data-driven features. Work closely with the product and engineering team to understand what data is needed to power customer-facing features, and ensure the right data arrives in the right shape at the right time. Push back when upstream data quality makes a feature untrustworthy. Set the standards for how we do integration. As our first dedicated integration engineer, you'll define how we approach connection design, error handling, retries, and monitoring. Document your decisions and build systems that future engineers can extend without fear. WHAT WE'RE 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—you've worked in small teams where you had to figure things out from scratch, own decisions end-to-end, and move without a lot of process. - Strong communication skills; you can explain a complex integration failure to a non-technical operator as clearly as you 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. COMPENSATION $160,000–$195,000 depending on experience. We also offer equity, competitive benefits, and a hybrid work environment in New York City. If you're excited about this role, we encourage you to apply even if you don't meet every requirement listed. We care more about your ability to build and operate complex systems in ambiguous environments than any single line on your resume.