3–5+ years in a technical healthcare IT role (Integration Engineer, PACS Admin, Systems Analyst, or similar). Mastery of DICOM (image routing, metadata structures, interoperability quirks). Familiarity with PACS/VNA environments and clinical imaging workflows. Experience with Mirth Connect, integration engines, or scripting HL7. Programming skills in Python, JavaScript, or similar. Experience with PostgreSQL, cloud-based storage, and modern deployment pipelines. Working knowledge of healthcare privacy and security regulations (HIPAA, GDPR, etc.).