Nick Dugan
Solutions Architect Liaison Fhir Interoperability Consultant @EviCore by Evernorth
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WORK HISTORY
Solutions Architect Liaison Fhir Interoperability Consultant @EviCore by Evernorth
Client-facing Solutions Architect and FHIR Interoperability Consultant supporting enterprise payer-provider interoperability, utilization management platforms, and regulatory modernization initiatives.•Lead interoperability and integration strategy across FHIR-native APIs, HL7 v2, X12, and document-based exchange workflows•Serve as FHIR Interoperability Consultant for implementations of Da Vinci PAS, DTR, CRD, and CDex •Provides technical guidance for FHIR R4, SMART-on-FHIR, OAuth2, payload validation, event-driven and asynchronous workflows, and subscription/notification models.•Act as escalation point for complex cross-system defects involving authorization lifecycle management, identifier persistence, ClaimResponse alignment, and multi-system correlation logic.•Design and validate end-to-end authorization and clinical data exchange workflows aligned to eviCore’s UM platforms, clinical decisioning systems, and enterprise data pipelines.•Partner with data engineering teams on real-time APIs and batch ETL flows, including Bronze/Silver/Gold transformations, UID mapping, and downstream analytics readiness.•Serve as liaison across Product, Engineering, Clinical, Data, and Client teams, mentoring junior architects and supporting pre-sales technical evaluations.Technologies & StandardsInteroperability & MessagingFHIR R4 • Da Vinci PAS / DTR / CRD / CDex • HL7 v2 • X12 (278/275) • CDA / document-based exchangeAPIs & Integration PatternsRESTful APIs • Event-driven & asynchronous workflows • Subscriptions & notifications • Payload validation & conformance testingIdentity, Security & AuthOAuth2 • SMART-on-FHIR • Token-based auth • Identifier persistence & correlation strategiesData Platforms & ArchitectureEnterprise UM platforms • Real-time + batch ETL pipelines • Bronze/Silver/Gold architectures • UID mapping • Data governance & auditability
EDUCATION
CT State Naugatuck Valley
Associate's degree, Registered Nursing/Registered Nurse
University of Hartford
RN-BSN, Health Science, Critical Care Nursing
ABOUT NICK DUGAN
I specialize in patient–provider–payer interoperability, utilization management systems, and healthcare data integration, working at the intersection of clinical workflows, regulatory requirements, and production engineering. My work spans FHIR-native APIs, legacy standards (HL7 v2, X12), real-time and batch data pipelines, and the architectural decisions required to make these systems reliable, compliant, and usable in the real world.Earlier in my career, I worked deeply in clinical informatics, healthcare analytics, and platform engineering, supporting provider organizations and health systems with data governance, integration, and workflow modernization. That foundation informs how I approach interoperability today—grounding modern API-driven solutions in an understanding of legacy systems, operational constraints, and clinical realities.In recent years, I’ve led and advised implementations of FHIR-based interoperability initiatives, including Da Vinci PAS, DTR, CRD, and CDex, translating complex regulatory and standards-driven requirements into implementable architectures, testable integrations, and production-ready workflows. I’m frequently brought in when integrations are ambiguous, failing, or crossing organizational boundaries between product, engineering, clinical, and client teams.What differentiates my work is clinical context combined with systems thinking. I don’t design APIs or data flows in isolation—I design them with an understanding of how they affect patients, clinicians, operations teams, and downstream decision-making. This perspective allows me to reduce integration friction, anticipate edge cases, and align technical solutions with real healthcare delivery and administrative realities.I’ve served as a client-facing technical lead, mentor to architects and engineers, and trusted partner to product and business stakeholders—supporting everything from regulatory modernization efforts to non-regulatory platform integrations and pre-sales technical evaluations.
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