Software · AI · Data · Salesforce · Security

Software engineer and architect for healthcare.

Nineteen years writing production code: data platforms, AI systems, Salesforce Health Cloud, and HIPAA-compliant infrastructure. You work with me directly from scoping through handoff. Available nationwide as 1099 or S-Corp.

19

Years in production

500+

dbt models shipped

5,000+

Daily calls supported

10,000+

Workers on Workday migrated

Client feedback

5.0 rating across every engagement.

"Exceedingly competent, clear, warm, conscientious, timely, incredibly organized. I would welcome the opportunity to work with Chris any time in my career."

5.0 ★★★★★

"Chris is one of the best freelancers I have ever had the opportunity to hire."

Nov 2022 ★★★★★

Endorsed for: clear communication, reliability, attention to detail, quality of work.

Verified client reviews

Services

Six areas where I deliver production systems.

Not advisory decks. Working software, configured platforms, and deployed infrastructure.

AI & agentic systems

Agentic AI workflows deployed in production clinical environments. Claude and Gemini APIs routed through zero-retention endpoints, GraphRAG over clinical documents. HIPAA-compliant endpoints with a signed BAA before any PHI touches a model.

Data engineering & analytics

Databricks lakehouses with 500+ dbt models, automated data contracts, and incremental CDC pipelines. Value-based care analytics: HEDIS and Stars quality reporting, CMS-HCC risk adjustment feeds, and population health dashboards.

Salesforce architecture

Health Cloud, Service Cloud, Marketing Cloud, and Sales Cloud. Patient 360 views, care coordination, risk stratification, Agentforce, and EHR integration via FHIR R4 and HL7. EHR vendors integrated: Epic, eClinicalWorks, Cerner.

Security & compliance

HIPAA, TCPA, PCI DSS, and RADV audit readiness. Preparing clinics for the proposed 2026 HIPAA Security Rule update: mandatory MFA, encryption at rest and in transit, and annual security risk assessments. Entra ID Conditional Access, Elastic SIEM, and Microsoft Defender for Endpoint deployed across multi-site clinic networks.

Solution architecture

Architecture reviews, technology selection, vendor evaluation, and team mentoring. Also available for interim CTO coverage during leadership searches or M&A transitions, and technical due diligence on acquisition targets.

When to call

You might need me if...

Your team needs senior technical leadership, not a full-time hire

You have developers but no one architecting the system. You need someone who can design the data model, write the critical path code, and mentor the team. A fractional engagement gives you principal-level architecture without the headcount.

AI is a priority but you need a practical roadmap

You need someone who has deployed AI in production, not someone who read a whitepaper. I help you separate the use cases that create value from the ones that create HIPAA risk, then build the ones worth building.

Your Salesforce implementation needs a healthcare specialist

Salesforce is configured but not adopted. Or you need Health Cloud and your current team has never implemented it. Or your patient outreach is manual when it should be automated.

You need data pipelines built, not just designed

Your data warehouse is a collection of exports and manual reports. You need governed metrics, automated pipelines, and dashboards your operations team trusts.

Your security posture needs to survive an audit

HIPAA, RADV, PCI DSS. You know you have gaps but you are not sure where. I assess, prioritize, and fix.

You have a project no one has solved yet

The integration that seems impossible. The data problem no one can untangle. The system that needs to exist but no vendor sells.

Selected work

Systems shipped, with outcomes.

Representative engagements across 19 years. Details de-identified where required by compliance.

01

Enterprise data platform from scratch

Databricks · dbt · 500+ models · 30+ dashboards

Challenge: Reporting was scattered across Tableau workbooks with no governance, no data contracts, and no single source of truth.

Approach: Architected and built the platform from the ground up. 500+ dbt models on Databricks with governed metric registries and automated data contracts. Incremental CDC pipelines feeding 30+ production dashboards.

Result: Migrated from Tableau with zero reporting gaps for clinical operations. Eliminated per-seat licensing spend. Self-service analytics adopted by every clinical operations team.

02

Salesforce scaling for urgent care network

Salesforce · 5 to 250 users · 5,000+ daily clinical calls

Challenge: Salesforce adoption stuck at 5 users with no unified customer view across a high-volume urgent care network.

Approach: Led growth from 5 to 250 users across Marketing, Sales, Service, and Health Cloud. Managed 15 onshore and offshore developers. Built unified 360-degree customer view.

Result: Platform became operational backbone for 5,000+ daily clinical calls. Scaled to support the full urgent care network.

03

Governed agentic AI in production

Claude & Gemini APIs · LiteLLM · CodeAnt · Cursor

Challenge: Engineering team needed AI-assisted development but without breaking changes reaching production.

Approach: Deployed agentic AI workflows with quality gates embedded in CI/CD. LiteLLM model routing for task-appropriate model selection. Human review stayed in the loop.

Result: Breaking changes caught before production. Development velocity increased on routine work while governance was maintained.

04

Multi-acquisition IT integration

M&A · Technical due diligence · Systems integration · Shared services

Challenge: Two major acquisitions needed IT integration without disrupting clinical operations.

Approach: Led technical due diligence on both targets, then merged equally sized IT organizations into a unified shared-services model. Owned IT strategy, budget, compliance, and multi-team organization through the transition.

Result: Zero clinical disruption during integration. Unified IT operations across the combined organization.

05

Workday HCM migration for 10,000 workers

Workday · Financials & HCM · Full platform migration

Challenge: Legacy HR and financial systems needed replacement across an organization with 10,000 workers.

Approach: Architected and led the full Workday Financials and HCM migration. Data migration, integrations, and user adoption managed end to end.

Result: 10,000 workers migrated to Workday. Platform went live without disruption to payroll or HR operations.

Why work with me

Builder, not just advisor.

01

I ship code, not slide decks.

Many consultants advise, present, and recommend. Then someone else has to build it. I write the code, configure the platforms, and deploy the infrastructure. When I hand off a system, it works.

02

Every engagement gets principal-level attention.

No junior team learning on your project. No account manager relaying messages. You talk to the person building the system, every time.

03

Healthcare depth without healthcare-only limits.

My deepest experience is in healthcare: Medicare Advantage, urgent care, primary care, EHR systems. But I also bring patterns from outside healthcare when they help.

04

Independent and vendor-neutral.

I am not a reseller. I do not get kickbacks from vendors. When I recommend Salesforce, Databricks, or any other platform, it is because it fits your problem, not because it fits my partnership tier.

Technologies

Tools I work with in production.

AI & ML

  • Claude & Gemini APIs
  • LiteLLM model routing
  • GraphRAG & vector retrieval
  • LightGBM / Prophet
  • Cursor / agentic dev

Salesforce

  • Health / Service / Marketing / Sales Cloud
  • Agentforce
  • Apex & LWC
  • FHIR / HL7
  • MuleSoft

Data & analytics

  • Databricks Lakehouse
  • dbt (500+ models)
  • Snowflake
  • Prefect orchestration
  • Superset / AI/BI

Development

  • Go / Python / TypeScript
  • Apex / Visualforce
  • REST & GraphQL
  • Docker / Azure / GCP
  • CircleCI / Bitbucket

Security

  • Elastic SIEM
  • Microsoft Defender
  • Entra ID
  • HIPAA / TCPA / PCI / RADV
  • BAA governance

Enterprise

  • Workday HCM & Financials
  • Epic / eClinicalWorks
  • InterSystems / DbAmp
  • Microsoft 365 / Experience Cloud
Salesforce Data Architect Salesforce Platform Developer II Salesforce Front End Developer Salesforce Administrator

Co-author, peer-reviewed COVID-19 epidemiology study covering 6.1M tests across 2.8M patients. Published in Annals of Epidemiology.

Engagement

How I work.

01   DISCOVERY CALL

A 15-minute call to understand your problem, constraints, and timeline. No slides, no pitch deck. You describe what is broken or what you need to build. I ask questions. If I am not the right fit, I tell you on the call.

02   WRITTEN PROPOSAL

Within 2 to 3 business days, you get a written proposal with scope, timeline, cost, and deliverables. Fixed-scope or retainer, depending on the engagement type. AI tooling costs are included in my rate.

03   BUILD AND ITERATE

I work on your codebase, in your tools, against your CI/CD pipeline. You see commits, PRs, and test results. No black-box deliverables. Weekly check-ins keep scope and priorities aligned.

04   HANDOFF

Documentation, runbooks, and a knowledge transfer session so your team owns the result. I remain available for questions after the engagement ends.

Typical start: within 2 weeks of scoping. Available nationwide as 1099 or S-Corp, up to 20% travel.

FAQ

Common questions.

What types of projects do you take on?

Software development, AI and agentic systems, data engineering platforms, Salesforce implementations, solution architecture, and security. Engagements range from 2-week assessments to multi-phase implementations. Not sure if your project fits? Send a brief description through the form and I will tell you straight.

Do you use AI tools in your work, and how does that affect pricing?

Yes. AI-assisted development is part of my workflow. Tooling costs are included in my rate. You will not see separate API charges. Faster delivery on routine work frees time for the problems that require human judgment.

How do you handle PHI and HIPAA compliance with AI tools?

I evaluate each tool's data handling, BAA availability, and compliance posture before deploying in healthcare contexts. Production systems that touch clinical data use HIPAA-compliant endpoints with a signed BAA. AI tools used for development tasks like code generation do not interact with production PHI.

Do you work with existing Salesforce implementations or only new builds?

Both. A significant portion of my work involves auditing and fixing existing Salesforce orgs that have accumulated technical debt, and extending them with Health Cloud, Service Cloud, or custom functionality. I start with an org assessment before proposing changes.

Can you integrate Salesforce with our EHR system?

Yes. I have built integrations between Salesforce and Epic, eClinicalWorks, and other EHR systems using FHIR APIs, HL7 standards, InterSystems, DbAmp, and middleware like MuleSoft. The approach depends on your EHR and what data needs to flow.

What is your availability and location?

Based in Las Vegas, Nevada and available for engagements throughout the US, working across all time zones. I work as 1099 or S-Corp depending on your procurement requirements. Willing to travel up to 20% of the engagement for on-site work. Full background check available upon request. I respond to new inquiries within one business day.

How long does a Salesforce Health Cloud implementation take?

Most run four to nine months from kickoff to go-live. The timeline depends on EHR integration complexity, data quality, and how fast the organization can standardize clinical workflows. Configuration is rarely the bottleneck; decisions are. A single-department rollout with one EHR and clean data can finish in three to five months. A multi-facility rollout with bi-directional EHR sync runs nine months or more.

Can our clinicians use public AI tools like ChatGPT for patient notes under HIPAA?

Not without controls. Public AI tools that do not offer a Business Associate Agreement cannot legally process PHI. Pasting a discharge summary or patient message into a consumer chatbot is a reportable breach if the text contains identifiers. The safe pattern is to de-identify before any prompt, route through an endpoint that offers a BAA, or build an internal tool on a compliant model.

How much does an engagement cost?

Engagement scope varies too widely to price honestly from a web page. A 2-week architecture assessment, a fractional engagement, and a fixed-scope Health Cloud implementation are each priced differently. AI tooling costs are included in my rate with no separate API charges. A written quote is provided after a 15-minute scoping call. If budget is the main constraint, say so in the form and I will tell you straight whether your project is realistic before you spend time on a proposal.

What engagement models do you offer?

Three models. Project-based for defined deliverables with a clear scope and end date. Fractional CTO for ongoing technical leadership, typically 10 to 20 hours a week. Architecture decisions, critical-path code, team mentoring, and accountability for outcomes. Advisory retainer for a few hours a week of senior judgment on vendor selection, roadmap reviews, and security questionnaires without delivery ownership. I also take interim CTO assignments when a leadership seat is empty during a search or M&A transition. Most of my work sits in the project-based and fractional categories. I write the code, design the systems, and own delivery.

About

Chris Gainus

Software engineer and architect with 19 years across data engineering, AI systems, Salesforce Health Cloud, security, and software development. I started in clinical psychology, moved into healthcare informatics, and built a career translating complex operational problems into working technology systems.

My work spans the full stack: scaling Salesforce from 5 to 250 users for a network handling 5,000+ daily urgent care calls, building a 500+ model dbt data platform on Databricks, deploying agentic AI workflows in production with governance and compliance, migrating Workday for 10,000 workers, and integrating EHR systems including Epic and eClinicalWorks.

Eight Salesforce certifications. Based in Las Vegas. Available nationwide as 1099 or S-Corp, up to 20% travel.

Salesforce certified

4 certs

Data Architect, Platform Developer II, Front End, Admin

Location

Las Vegas, NV

Available nationwide, up to 20% travel

Engagement

1099 / S-Corp

Background check available upon request

Contact

Tell me what you're building.

Describe your project, timeline, and what you are trying to solve. I read every submission myself and respond within one business day. Prefer to talk first? Mention "intro call" and I will send a scheduling link.

chris@pumatech.dev

Based in Las Vegas, NV. Available nationwide. 1099 or S-Corp. Up to 20% travel.