Pivotal Health

Build and own the company's security program, establish strategy and policies, embed security into platform, and lead compliance efforts. | 8+ years in security with cloud, infrastructure, and application security experience and compliance framework expertise. | About Pivotal Health Pivotal Health is the leading technology platform that helps healthcare providers get paid fairly in an increasingly complex reimbursement landscape. Today, many providers face persistent underpayment from health insurance companies, despite delivering high-quality care. While processes like IDR (Independent Dispute Resolution) were designed to promote fairness, they’re often administrative-heavy, time-consuming, and difficult to navigate without the right tools. Pivotal Health combines software, data, and service into a seamlessly integrated, AI-driven platform that simplifies these complex reimbursement workflows. We help providers efficiently dispute underpaid claims, reduce administrative burden, and recover the reimbursement they’re entitled to; without adding more work to already stretched teams. Our full-service IDR solution is just the starting point. We’re building solutions that enable providers to operate with clarity, control, and confidence across the reimbursement journey. About the role We're hiring Pivotal's Head of Security, a senior leader who will own the company's security program from the ground up. This is a rare opportunity to define what security looks like at a fast-growing, AI-native healthcare technology company handling sensitive provider data and complex financial workflows. This role sits at the intersection of strategy, engineering, compliance, and customer trust. You'll work closely with key stakeholders across the organization to embed security across the organization. Not just as a technical function, but as a core part of how Pivotal builds, operates, and earns the confidence of the providers and partners it serves. You'll bring enough technical depth to engage credibly with our engineering teams, and enough breadth to set organizational strategy, navigate the regulatory landscape, and represent Pivotal's security posture to customers, auditors, and key stakeholders. If you're energized by building something meaningful from scratch and want your work to matter beyond a checklist, this is the role for you. What you'll do Build and own Pivotal's security program Establish the strategy, policies, processes, and roadmap that define Pivotal's security posture. Identify the company's most critical assets, prioritize risk accordingly, and build a program that scales alongside a fast-growing platform and team. Partner with engineering to embed security into the platform Work closely with engineering and infrastructure teams to ensure security is built into how we design, develop, and deploy — from cloud architecture and CI/CD pipelines to data access controls and third-party integrations. You'll advocate for secure-by-design practices without slowing the team down. Lead compliance and regulatory readiness Own Pivotal's approach to relevant compliance frameworks, including SOC 2 and HIPAA. Translate regulatory requirements into actionable engineering and operational controls, lead audit preparation, and serve as the primary point of contact during security reviews. Stay ahead of the threat landscape Keep a close eye on the evolving security environment — emerging threats, new attack vectors, regulatory changes, and industry best practices. Bring that awareness into how Pivotal prioritizes and evolves its defenses over time. Interface with customers and external stakeholders Represent Pivotal's security program directly to customers, partners, and prospects. Answer security questionnaires, lead trust reviews, and give customers confidence that their data — and their providers' data — is in safe hands. Drive security awareness across the organization Champion a security-conscious culture companywide. Work with teams outside of engineering — including finance, operations, and people — to ensure security practices extend beyond the codebase and into how the whole organization operates. Develop guidelines for emerging technologies As an AI-native company, Pivotal is actively building with and around LLMs and AI tooling. Help define the guardrails for responsible, secure use of these technologies — both in our product and in our internal workflows. Who you are 8+ years of experience in security, with meaningful exposure to both technical implementation and program-level strategy Strong working knowledge of cloud security, infrastructure security, and application security fundamentals, enough to engage credibly with engineering teams and evaluate tradeoffs Experience building or significantly maturing a security program, ideally at an early-stage or high-growth company Hands-on experience with compliance frameworks (SOC 2, HIPAA, or similar) including control design, audit preparation, and ongoing management Comfortable representing security externally to customers, auditors, and partners with the communication skills to make complex topics accessible A collaborator and influencer, not just a gatekeeper: you know how to bring stakeholders along and build trust across functions Comfortable operating in ambiguity and building from scratch: you're energized by greenfield work, not slowed down by it Up to date on the current threat landscape, security tooling, and best practices: you stay informed and bring that knowledge into your work Extra credit if you have Experience in HealthTech, FinTech, or other regulated industries handling sensitive data Background working with financial systems, payments infrastructure, or data-intensive platforms Familiarity with AI/LLM security considerations and responsible AI deployment practices Experience managing or growing a security team Why You’ll Love Working Here We’re a collaborative, low-ego team on a mission to make healthcare reimbursement fairer for providers. While we primarily hire around our core hubs–Los Angeles and New York–we remain open to exceptional talent outside those regions. Remote and hybrid flexibility varies by role and team, and is outlined in each job description. If you’re excited by solving complex problems and making a real-world impact, we’d love to hear from you. Benefits Include: Competitive compensation, including equity Full health, dental, and vision coverage Retirement savings plan through 401(k) Flexible time off Opportunities for company-wide connection and events Ready to Make an Impact? We’re building something meaningful; and we want you on the team. Bring your ideas, curiosity, and drive, and let’s transform healthcare reimbursement together. Employment Information Work Authorization Candidates must be authorized to work in the United States without current or future employer sponsorship. Equal Employment Opportunity Pivotal Health is an Equal Opportunity Employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. We do not discriminate on the basis of race, color, religion, sex, gender identity or expression, sexual orientation, national origin, age, disability, veteran status, or any other legally protected status. Reasonable Accommodations Pivotal Health provides reasonable accommodations for qualified individuals with disabilities in accordance with applicable laws. If you need assistance during the application or interview process, please let us know. Background Checks Employment is contingent upon successful completion of applicable background checks, where permitted by law. At-Will Employment Employment with Pivotal Health is at-will and may be terminated by either party at any time, with or without cause or notice, in accordance with applicable law.

Design and maintain backend systems and APIs integrating external healthcare data sources, owning integration pipelines and collaborating cross-functionally. | 5+ years backend engineering experience with system design and third-party API integrations, comfortable with complex real-world data in fast-paced environments. | About Pivotal Health Pivotal Health is the leading technology platform that helps healthcare providers get paid fairly in an increasingly complex reimbursement landscape. Today, many providers face persistent underpayment from health insurance companies, despite delivering high-quality care. While processes like IDR (Independent Dispute Resolution) were designed to promote fairness, they’re often administrative-heavy, time-consuming, and difficult to navigate without the right tools. Pivotal Health combines software, data, and service into a seamlessly integrated, AI-driven platform that simplifies these complex reimbursement workflows. We help providers efficiently dispute underpaid claims, reduce administrative burden, and recover the reimbursement they’re entitled to; without adding more work to already stretched teams. Our full-service IDR solution is just the starting point. We’re building solutions that enable providers to operate with clarity, control, and confidence across the reimbursement journey. About the Role We're hiring a Senior Software Engineer to join Pivotal's Integrations team. You'll build and own the backend systems that connect Pivotal's platform to the external data sources, healthcare platforms, billing tools, and partner APIs that our clients and providers depend on. This is a full-ownership role on a small, fast-moving team that is still defining itself. You'll work closely with product, contribute to architectural decisions, and take real accountability for what you ship. The work involves messy real-world data, evolving integration requirements, and close collaboration with internal and external stakeholders, the right person is energized by that, not slowed down by it. What You'll Do Build and own backend integrations: Design, implement, and maintain the services, pipelines, and APIs that connect Pivotal's platform to external healthcare systems, billing tools, and partner data sources. Take end-to-end ownership from design through production. Work with real-world healthcare data: Build integrations that handle the practical realities of healthcare data like SFTP-based ingestion, evolving file formats, inconsistent schemas, and complex onboarding workflows with pragmatism and care. Contribute to architectural decisions: Be an active participant in technical planning and design discussions. Bring your implementation perspective and push back when you see a better path. Operate with autonomy: With a small team and real ownership, there's no room for passengers. You'll identify what needs solving and drive your work forward without heavy oversight. Partner closely with product and stakeholders: Work directly with product to understand requirements, clarify scope, and translate integration needs into sound technical plans. Be comfortable in conversations that involve customers, partners, or domain complexity. Write reliable, maintainable code: Hold a high bar for code quality, testing, and system design. Correctness matters here, these integrations affect real clinical and financial data. Surface problems early: Communicate blockers, risks, and open questions proactively. Keeping the team aligned is part of doing the job well. Who You Are 5+ years of software engineering experience with a strong backend focus Solid understanding of backend fundamentals: system design, data modeling, API development, and service reliability Comfortable working with database-heavy systems and building around messy, real-world data Experience building or maintaining integrations with third-party APIs, data pipelines, or external enterprise systems Comfortable in greenfield environments with evolving requirements and ambiguous ownership Able to collaborate closely with product, customers, and partners, not just engineering teammates Self-directed and proactive: you identify problems and drive them to resolution Strong communicator who surfaces ambiguity early and works well across functions Experience in early-stage or startup environments where engineers own outcomes, not just tasks Extra Credit If You Have Experience with healthcare integrations: EDI workflows (835/837), HL7/FHIR, ICD-10/CPT codes, or platforms like Epic or Cerner Experience with SFTP-based ingestion, data sharing pipelines, or clinical data access workflows Familiarity with Python in production backend environments Background in integration-heavy or forward-deployed engineering roles Background in FinTech, HealthTech, or other regulated industries handling sensitive data Familiarity with Python a plus Why You’ll Love Working Here We’re a collaborative, low-ego team on a mission to make healthcare reimbursement fairer for providers. While we primarily hire around our core hubs–Los Angeles and New York–we remain open to exceptional talent outside those regions. Remote and hybrid flexibility varies by role and team, and is outlined in each job description. If you’re excited by solving complex problems and making a real-world impact, we’d love to hear from you. Benefits Include: Competitive compensation, including equity Full health, dental, and vision coverage Retirement savings plan through 401(k) Flexible time off Opportunities for company-wide connection and events Ready to Make an Impact? We’re building something meaningful; and we want you on the team. Bring your ideas, curiosity, and drive, and let’s transform healthcare reimbursement together. Employment Information Work Authorization Candidates must be authorized to work in the United States without current or future employer sponsorship. Equal Employment Opportunity Pivotal Health is an Equal Opportunity Employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. We do not discriminate on the basis of race, color, religion, sex, gender identity or expression, sexual orientation, national origin, age, disability, veteran status, or any other legally protected status. Reasonable Accommodations Pivotal Health provides reasonable accommodations for qualified individuals with disabilities in accordance with applicable laws. If you need assistance during the application or interview process, please let us know. Background Checks Employment is contingent upon successful completion of applicable background checks, where permitted by law. At-Will Employment Employment with Pivotal Health is at-will and may be terminated by either party at any time, with or without cause or notice, in accordance with applicable law.

Design and maintain backend systems and APIs for onboarding and growth tooling while collaborating cross-functionally. | Requires 5+ years backend-focused software engineering experience, strong product instincts, and ability to work autonomously in a startup environment. | About Pivotal Health Pivotal Health is the leading technology platform that helps healthcare providers get paid fairly in an increasingly complex reimbursement landscape. Today, many providers face persistent underpayment from health insurance companies, despite delivering high-quality care. While processes like IDR (Independent Dispute Resolution) were designed to promote fairness, they’re often administrative-heavy, time-consuming, and difficult to navigate without the right tools. Pivotal Health combines software, data, and service into a seamlessly integrated, AI-driven platform that simplifies these complex reimbursement workflows. We help providers efficiently dispute underpaid claims, reduce administrative burden, and recover the reimbursement they’re entitled to; without adding more work to already stretched teams. Our full-service IDR solution is just the starting point. We’re building solutions that enable providers to operate with clarity, control, and confidence across the reimbursement journey. About the Role We're hiring a Senior Software Engineer to join Pivotal's Growth & Onboarding team. This is a primarily backend-focused role building the systems that power how new providers onboard to the platform, get configured, and start realizing value, a surface that directly shapes the customer experience and Pivotal's ability to scale. You'll build practical, customer-facing tools and workflows tied to onboarding and growth, working closely not just with product and engineering but with sales and marketing stakeholders who depend on this team as a key touchpoint in the customer lifecycle. Strong product instincts and a genuine interest in what customers need earliest in their journey are just as important as technical depth here. What You'll Do Build and own backend systems: Design, implement, and maintain the services and APIs that power provider onboarding, activation, customization workflows, and growth-oriented tooling. Take end-to-end ownership from design through production. Build practical customer-facing tools: Translate what providers, sales, and marketing need at the earliest stages of the customer lifecycle into reliable, well-designed backend systems and workflows. Contribute to architectural decisions: Be an active participant in technical planning and design discussions. Bring your implementation perspective and push back when you see a better path. Partner cross-functionally: Work closely with product, sales, and marketing stakeholders, not just engineering. This team is a key customer touchpoint and the right person is comfortable in that cross-functional environment. Operate with autonomy: With a small team and real ownership, there's no room for passengers. You'll identify what needs solving and drive your work forward without heavy oversight. Write reliable, maintainable code: Hold a high bar for code quality, testing, and system design. Build things that hold up as the platform and team scale. Surface problems early: Communicate blockers, risks, and open questions proactively. Keeping the team aligned is part of doing the job well. Who You Are 5+ years of software engineering experience with a strong backend focus Solid understanding of backend fundamentals: system design, data modeling, API development, and service reliability Strong product orientation with good instincts around customer needs and usability: you think about the person using the thing, not just the system underneath it Python experience preferred; candidates from other backend languages are welcome if they're prepared to interview in Python and ramp quickly Comfortable working in product-driven environments with cross-functional stakeholders including sales and marketing Comfortable in greenfield environments with evolving requirements Self-directed and proactive: you identify problems and drive them to resolution Strong communicator who surfaces ambiguity early and collaborates well across functions Experience in early-stage or startup environments where engineers own outcomes, not just tasks Extra Credit If You Have Experience building onboarding flows, activation funnels, customization tooling, or growth-oriented product features Familiarity with sales or marketing support tooling or benchmarking tools Familiarity with experimentation, feature flagging, or A/B testing Background in FinTech, HealthTech, or other regulated industries Familiarity with Python a plus Why You’ll Love Working Here We’re a collaborative, low-ego team on a mission to make healthcare reimbursement fairer for providers. While we primarily hire around our core hubs–Los Angeles and New York–we remain open to exceptional talent outside those regions. Remote and hybrid flexibility varies by role and team, and is outlined in each job description. If you’re excited by solving complex problems and making a real-world impact, we’d love to hear from you. Benefits Include: Competitive compensation, including equity Full health, dental, and vision coverage Retirement savings plan through 401(k) Flexible time off Opportunities for company-wide connection and events Ready to Make an Impact? We’re building something meaningful; and we want you on the team. Bring your ideas, curiosity, and drive, and let’s transform healthcare reimbursement together. Employment Information Work Authorization Candidates must be authorized to work in the United States without current or future employer sponsorship. Equal Employment Opportunity Pivotal Health is an Equal Opportunity Employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. We do not discriminate on the basis of race, color, religion, sex, gender identity or expression, sexual orientation, national origin, age, disability, veteran status, or any other legally protected status. Reasonable Accommodations Pivotal Health provides reasonable accommodations for qualified individuals with disabilities in accordance with applicable laws. If you need assistance during the application or interview process, please let us know. Background Checks Employment is contingent upon successful completion of applicable background checks, where permitted by law. At-Will Employment Employment with Pivotal Health is at-will and may be terminated by either party at any time, with or without cause or notice, in accordance with applicable law.

Lead integrations team managing engineers and engineering strategy while coding systems connecting platform to healthcare data and partner APIs. | 6+ years software engineering with 2+ years managing engineers, strong third-party API integration experience, and customer-facing technical discovery skills required. | About Pivotal Health Pivotal Health is the leading technology platform that helps healthcare providers get paid fairly in an increasingly complex reimbursement landscape. Today, many providers face persistent underpayment from health insurance companies, despite delivering high-quality care. While processes like IDR (Independent Dispute Resolution) were designed to promote fairness, they’re often administrative-heavy, time-consuming, and difficult to navigate without the right tools. Pivotal Health combines software, data, and service into a seamlessly integrated, AI-driven platform that simplifies these complex reimbursement workflows. We help providers efficiently dispute underpaid claims, reduce administrative burden, and recover the reimbursement they’re entitled to; without adding more work to already stretched teams. Our full-service IDR solution is just the starting point. We’re building solutions that enable providers to operate with clarity, control, and confidence across the reimbursement journey. About the Role We're hiring a hands-on Engineering Manager to lead Pivotal's Integrations team, a backend-focused group building the infrastructure that connects our platform to the external systems our clients and providers depend on, including healthcare data sources, EHR platforms, billing systems, and partner APIs. This team is new and still taking shape, which means the right EM isn't just leading a function, they're helping define it. You'll be involved in customer and partner conversations, shaping how the team approaches integration problems at a technical and product level, and building a team that can work fluidly across messy real-world data, evolving requirements, and close customer collaboration. This is a true player-coach role. You will write code, drive delivery, and raise the bar for engineering quality today while also developing the team and establishing strong practices as we scale. If you're energized by greenfield scope, external-facing work, and the challenge of building something new, this role is for you. What You'll Do Stand up and shape a new team: Help define how the Integrations function operates (hiring, scope, rituals, and engineering culture) while the team is still being built and ownership boundaries are still being established. Lead as a player-coach: Contribute code, perform design reviews and PRs, and guide technical strategy while supporting the growth and effectiveness of the team. Own the Integrations surface: Take end-to-end engineering ownership of the systems that connect Pivotal's platform to customers, external data sources, healthcare platforms,, and any partner APIs. Ensure integrations are reliable, scalable, and maintainable as the catalog grows. Join customer and partner conversations: Be the technical voice in discovery and scoping conversations with customers and external partners. Ask the right questions, understand integration requirements deeply, and bring that context back into engineering execution. Partner deeply with product: Collaborate closely with product to gather requirements, clarify scope, and translate integration needs into executable technical plans. Help shape solutions early rather than reacting late. Drive execution and delivery: Own the engineering side of delivery (sprint planning, standups, retros, prioritization) ensuring the team ships consistently and learns from each cycle. Translate ambiguity into clarity: Take loosely defined problems and help the team break them down into clear, achievable work with well-understood tradeoffs and success criteria. Build lightweight process and rituals: Establish and evolve team workflows that improve focus and predictability without unnecessary ceremony. Support and grow engineers: Coach engineers on execution, communication, and ownership across both IC and managerial tracks. Who You Are Bachelor's degree in STEM preferred; additional experience in lieu of a degree is also accepted 6+ years of professional software engineering experience, including recent hands-on backend work 2+ years of experience managing and developing engineers Experience building or owning integrations with third-party APIs, healthcare systems, and data-heavy enterprise software Strong customer-facing communication skills: you're comfortable in external conversations with customers and partners, not just internal stakeholders Able to ask the right technical and business questions in discovery conversations and translate what you learn into engineering direction Comfortable shaping team scope, contributing to hiring, and helping define a function that is still emerging Experience working in product-driven environments with close product partnership Strong technical judgment with a bias toward pragmatic, shippable solutions Able to balance near-term delivery with longer-term technical health Clear communicator who builds trust across engineering, product, and external partners Thrives in early-stage or scaling environments where structure is evolving Extra Credit Experience Experience in healthcare integrations: EDI workflows (835/837), HL7/FHIR, ICD-10/CPT codes, or platforms like Epic or Cerner Background in integration-heavy or forward-deployed engineering roles where customer proximity was part of the job Experience with SFTP-based ingestion, data sharing pipelines, or clinical data access systems Familiarity with Python in production backend environments Experience at a Series A or early-stage startup where priorities evolve quickly and leaders wear multiple hats Background in FinTech, healthcare, or another highly regulated industry Familiarity with Python a plus Why You’ll Love Working Here We’re a collaborative, low-ego team on a mission to make healthcare reimbursement fairer for providers. While we primarily hire around our core hubs–Los Angeles and New York–we remain open to exceptional talent outside those regions. Remote and hybrid flexibility varies by role and team, and is outlined in each job description. If you’re excited by solving complex problems and making a real-world impact, we’d love to hear from you. Benefits Include: Competitive compensation, including equity Full health, dental, and vision coverage Retirement savings plan through 401(k) Flexible time off Opportunities for company-wide connection and events Ready to Make an Impact? We’re building something meaningful; and we want you on the team. Bring your ideas, curiosity, and drive, and let’s transform healthcare reimbursement together. Employment Information Work Authorization Candidates must be authorized to work in the United States without current or future employer sponsorship. Equal Employment Opportunity Pivotal Health is an Equal Opportunity Employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. We do not discriminate on the basis of race, color, religion, sex, gender identity or expression, sexual orientation, national origin, age, disability, veteran status, or any other legally protected status. Reasonable Accommodations Pivotal Health provides reasonable accommodations for qualified individuals with disabilities in accordance with applicable laws. If you need assistance during the application or interview process, please let us know. Background Checks Employment is contingent upon successful completion of applicable background checks, where permitted by law. At-Will Employment Employment with Pivotal Health is at-will and may be terminated by either party at any time, with or without cause or notice, in accordance with applicable law.

Lead technical direction and architecture for integration systems, deliver production code, mentor engineers, and collaborate cross-functionally. | 8+ years backend software engineering experience with architectural ownership and strong instincts for complex database and data transformation systems. | About Pivotal Health Pivotal Health is the leading technology platform that helps healthcare providers get paid fairly in an increasingly complex reimbursement landscape. Today, many providers face persistent underpayment from health insurance companies, despite delivering high-quality care. While processes like IDR (Independent Dispute Resolution) were designed to promote fairness, they’re often administrative-heavy, time-consuming, and difficult to navigate without the right tools. Pivotal Health combines software, data, and service into a seamlessly integrated, AI-driven platform that simplifies these complex reimbursement workflows. We help providers efficiently dispute underpaid claims, reduce administrative burden, and recover the reimbursement they’re entitled to; without adding more work to already stretched teams. Our full-service IDR solution is just the starting point. We’re building solutions that enable providers to operate with clarity, control, and confidence across the reimbursement journey. About the Role We're hiring a Staff Software Engineer to join Pivotal's Integrations team, a backend-focused group building the connections between our platform and the external systems that healthcare providers, clients, and partners depend on, including EHR platforms, billing systems, data feeds, and partner APIs. This is a high-ownership, high-autonomy role on a team that is still defining itself. Architecture, ownership boundaries, and integration patterns are all still being worked out, which means the right person can operate without a clear playbook and bring strong technical judgment to ambiguous problems. You'll be a hands-on technical leader and a force multiplier for the engineers around you and you'll have real influence over how this team approaches some of the hardest integration problems in healthcare. What You'll Do Own the technical direction for integration systems: Drive architectural decisions across the integrations this team builds and maintains, including healthcare data pipelines, SFTP-based ingestion workflows, EHR platform connections, and partner APIs. Set standards the rest of the team builds to. Build and ship production systems: Stay hands-on. Write production code, lead design reviews, and take end-to-end ownership of the systems you drive. Design practical systems around messy real-world data: Build integrations that are flexible enough to handle the realities of healthcare data (inconsistent formats, evolving schemas, and complex onboarding workflows) while maintaining clear technical boundaries. Bridge technical implementation and customer discovery: Help the team understand integration requirements deeply by engaging in problem discovery alongside product and, where relevant, customers and partners. Translate what you learn into sound technical plans. Translate ambiguity into executable plans: Partner with product and engineering leadership to take loosely defined requirements and turn them into clear, well-scoped work with understood tradeoffs. Raise the engineering bar: Establish patterns and practices through code, reviews, and direct collaboration that improve quality, reliability, and maintainability across the team. Operate cross-functionally: Work closely with product, data, platform, and DevOps partners to ensure integrations are secure, well-instrumented, and built for the long term. Mentor and grow engineers: Be a technical resource and thought partner for senior and mid-level engineers on the team. Who You Are 8+ years of software engineering experience with a strong backend focus Deep systems and database instincts: you're comfortable with database-heavy systems, evolving data pipelines, and the practical challenges of moving and transforming real-world data Track record of owning architectural decisions on complex, production systems Comfortable operating with high autonomy in ambiguous, greenfield environments where ownership and architecture are still being worked out Able to engage in customer and problem discovery: you bring curiosity and good questions, not just implementation depth Strong product instincts: you care about whether a system is actually useful and correct, not just technically elegant Self-directed and highly communicative: you surface problems early and drive work forward without waiting for direction Strong collaborator who can lead through influence and execution, not just title Extra Credit If You Have Experience with healthcare integrations: EDI workflows (835/837), HL7/FHIR, ICD-10/CPT codes, or platforms like Epic or Cerner Experience with SFTP-based ingestion pipelines, data sharing workflows, or clinical data access systems Background in integration-heavy or forward-deployed engineering where working with customer data was central Familiarity with Python in production backend environments Background in FinTech, HealthTech, or other data-intensive regulated industries Experience in startup or high-growth environments where engineers help define the product Familiarity with Python a plus Why You’ll Love Working Here We’re a collaborative, low-ego team on a mission to make healthcare reimbursement fairer for providers. While we primarily hire around our core hubs–Los Angeles and New York–we remain open to exceptional talent outside those regions. Remote and hybrid flexibility varies by role and team, and is outlined in each job description. If you’re excited by solving complex problems and making a real-world impact, we’d love to hear from you. Benefits Include: Competitive compensation, including equity Full health, dental, and vision coverage Retirement savings plan through 401(k) Flexible time off Opportunities for company-wide connection and events Ready to Make an Impact? We’re building something meaningful; and we want you on the team. Bring your ideas, curiosity, and drive, and let’s transform healthcare reimbursement together. Employment Information Work Authorization Candidates must be authorized to work in the United States without current or future employer sponsorship. Equal Employment Opportunity Pivotal Health is an Equal Opportunity Employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. We do not discriminate on the basis of race, color, religion, sex, gender identity or expression, sexual orientation, national origin, age, disability, veteran status, or any other legally protected status. Reasonable Accommodations Pivotal Health provides reasonable accommodations for qualified individuals with disabilities in accordance with applicable laws. If you need assistance during the application or interview process, please let us know. Background Checks Employment is contingent upon successful completion of applicable background checks, where permitted by law. At-Will Employment Employment with Pivotal Health is at-will and may be terminated by either party at any time, with or without cause or notice, in accordance with applicable law.

Lead technical direction and architecture for integration systems and mentor engineers. | 8+ years backend engineering with architectural ownership and experience in complex database systems. | About Pivotal Health Pivotal Health is the leading technology platform that helps healthcare providers get paid fairly in an increasingly complex reimbursement landscape. Today, many providers face persistent underpayment from health insurance companies, despite delivering high-quality care. While processes like IDR (Independent Dispute Resolution) were designed to promote fairness, they’re often administrative-heavy, time-consuming, and difficult to navigate without the right tools. Pivotal Health combines software, data, and service into a seamlessly integrated, AI-driven platform that simplifies these complex reimbursement workflows. We help providers efficiently dispute underpaid claims, reduce administrative burden, and recover the reimbursement they’re entitled to; without adding more work to already stretched teams. Our full-service IDR solution is just the starting point. We’re building solutions that enable providers to operate with clarity, control, and confidence across the reimbursement journey. About the Role We're hiring a Staff Software Engineer to join Pivotal's Integrations team, a backend-focused group building the connections between our platform and the external systems that healthcare providers, clients, and partners depend on, including EHR platforms, billing systems, data feeds, and partner APIs. This is a high-ownership, high-autonomy role on a team that is still defining itself. Architecture, ownership boundaries, and integration patterns are all still being worked out, which means the right person can operate without a clear playbook and bring strong technical judgment to ambiguous problems. You'll be a hands-on technical leader and a force multiplier for the engineers around you and you'll have real influence over how this team approaches some of the hardest integration problems in healthcare. What You'll Do Own the technical direction for integration systems: Drive architectural decisions across the integrations this team builds and maintains, including healthcare data pipelines, SFTP-based ingestion workflows, EHR platform connections, and partner APIs. Set standards the rest of the team builds to. Build and ship production systems: Stay hands-on. Write production code, lead design reviews, and take end-to-end ownership of the systems you drive. Design practical systems around messy real-world data: Build integrations that are flexible enough to handle the realities of healthcare data (inconsistent formats, evolving schemas, and complex onboarding workflows) while maintaining clear technical boundaries. Bridge technical implementation and customer discovery: Help the team understand integration requirements deeply by engaging in problem discovery alongside product and, where relevant, customers and partners. Translate what you learn into sound technical plans. Translate ambiguity into executable plans: Partner with product and engineering leadership to take loosely defined requirements and turn them into clear, well-scoped work with understood tradeoffs. Raise the engineering bar: Establish patterns and practices through code, reviews, and direct collaboration that improve quality, reliability, and maintainability across the team. Operate cross-functionally: Work closely with product, data, platform, and DevOps partners to ensure integrations are secure, well-instrumented, and built for the long term. Mentor and grow engineers: Be a technical resource and thought partner for senior and mid-level engineers on the team. Who You Are 8+ years of software engineering experience with a strong backend focus Deep systems and database instincts: you're comfortable with database-heavy systems, evolving data pipelines, and the practical challenges of moving and transforming real-world data Track record of owning architectural decisions on complex, production systems Comfortable operating with high autonomy in ambiguous, greenfield environments where ownership and architecture are still being worked out Able to engage in customer and problem discovery: you bring curiosity and good questions, not just implementation depth Strong product instincts: you care about whether a system is actually useful and correct, not just technically elegant Self-directed and highly communicative: you surface problems early and drive work forward without waiting for direction Strong collaborator who can lead through influence and execution, not just title Extra Credit If You Have Experience with healthcare integrations: EDI workflows (835/837), HL7/FHIR, ICD-10/CPT codes, or platforms like Epic or Cerner Experience with SFTP-based ingestion pipelines, data sharing workflows, or clinical data access systems Background in integration-heavy or forward-deployed engineering where working with customer data was central Familiarity with Python in production backend environments Background in FinTech, HealthTech, or other data-intensive regulated industries Experience in startup or high-growth environments where engineers help define the product Familiarity with Python a plus Why You’ll Love Working Here We’re a collaborative, low-ego team on a mission to make healthcare reimbursement fairer for providers. While we primarily hire around our core hubs–Los Angeles and New York–we remain open to exceptional talent outside those regions. Remote and hybrid flexibility varies by role and team, and is outlined in each job description. If you’re excited by solving complex problems and making a real-world impact, we’d love to hear from you. Benefits Include: Competitive compensation, including equity Full health, dental, and vision coverage Retirement savings plan through 401(k) Flexible time off Opportunities for company-wide connection and events Ready to Make an Impact? We’re building something meaningful; and we want you on the team. Bring your ideas, curiosity, and drive, and let’s transform healthcare reimbursement together. Employment Information Work Authorization Candidates must be authorized to work in the United States without current or future employer sponsorship. Equal Employment Opportunity Pivotal Health is an Equal Opportunity Employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. We do not discriminate on the basis of race, color, religion, sex, gender identity or expression, sexual orientation, national origin, age, disability, veteran status, or any other legally protected status. Reasonable Accommodations Pivotal Health provides reasonable accommodations for qualified individuals with disabilities in accordance with applicable laws. If you need assistance during the application or interview process, please let us know. Background Checks Employment is contingent upon successful completion of applicable background checks, where permitted by law. At-Will Employment Employment with Pivotal Health is at-will and may be terminated by either party at any time, with or without cause or notice, in accordance with applicable law.

Manage high-volume, full-cycle recruiting across multiple functions with proactive sourcing and stakeholder partnership. | 4-7+ years recruiting experience, strong sourcing skills, ability to manage multiple roles, and operate in fast-paced environments. | About Pivotal Health Pivotal Health is the leading technology platform that helps healthcare providers get paid fairly in an increasingly complex reimbursement landscape. Today, many providers face persistent underpayment from health insurance companies, despite delivering high-quality care. While processes like IDR (Independent Dispute Resolution) were designed to promote fairness, they're often administrative-heavy, time-consuming, and difficult to navigate without the right tools. Pivotal Health combines software, data, and service into a seamlessly integrated, AI-driven platform that simplifies these complex reimbursement workflows. We help providers efficiently dispute underpaid claims, reduce administrative burden, and recover the reimbursement they're entitled to; without adding more work to already stretched teams. Our full-service IDR solution is just the starting point. We're building solutions that enable providers to operate with clarity, control, and confidence across the reimbursement journey. About the Role We're looking for a Recruiting Generalist who knows how to operate at pace without lowering the bar. This is a high-volume, high-ownership role. You'll run full-cycle recruiting across a range of functions, from GTM to G&A, managing multiple searches at once while keeping quality high. Some roles will move quickly and require strong pipeline management. Others will need more precision. You'll need to know how to balance both. This is not a "post and pray" role. You'll be expected to proactively source, move candidates efficiently through process, and close strong talent in a competitive market. You'll operate as both a hands-on executor and a thought partner, someone who can keep things moving while also improving how we hire as we scale. If you've worked in agency recruiting or high-volume environments, you'll feel right at home here. This role is based in Los Angeles and requires regular in-office presence. What You'll Do • Run high-volume, full-cycle recruiting: Manage multiple open roles across functions, keeping pipelines full and processes moving efficiently from intake through close. • Source proactively and consistently: Build and maintain strong candidate pipelines. You don't wait for inbound - you go out and find talent. • Partner with hiring managers: Align on role scope, calibrate candidates, and keep stakeholders moving quickly and effectively through the process. • Operate with urgency and organization: Juggle multiple searches at once without letting details slip. You know how to prioritize and keep momentum. • Close candidates effectively: Guide candidates through the process, address concerns, and drive strong close rates. • Improve recruiting operations: Identify bottlenecks, refine workflows, and help build more efficient, scalable hiring processes. Who You Are • 4-7+ years of recruiting experience, ideally in agency or high-volume environments • Experience hiring across multiple functions (GTM, G&A, or technical) • Proven ability to manage multiple roles simultaneously without sacrificing quality • Strong sourcing skills; you know how to build pipeline from scratch • Comfortable operating in fast-paced, ambiguous environments • Highly organized with strong attention to detail • Confident communicator who can keep hiring teams aligned and accountable • Resilient, resourceful, and energized by a fast-moving environment Extra Credit Experience • Experience recruiting in early-stage or scaling startup environments (Series A through Series C) • Familiarity with tools like Ashby, LinkedIn Recruiter, and sourcing automation tools • Exposure to recruiting ops, interview design, or process improvement Why You'll Love Working Here We're a collaborative, low-ego team on a mission to make healthcare reimbursement fairer for providers. While we primarily hire around our core hubs-Los Angeles and New York-we remain open to exceptional talent outside those regions. Remote and hybrid flexibility varies by role and team, and is outlined in each job description. If you're excited by solving complex problems and making a real-world impact, we'd love to hear from you. Benefits Include: • Competitive compensation, including equity • Full health, dental, and vision coverage • Retirement savings plan through 401(k) • Flexible time off • Opportunities for company-wide connection and events Ready to Make an Impact?We're building something meaningful; and we want you on the team. Bring your ideas, curiosity, and drive, and let's transform healthcare reimbursement together. Employment Information Work Authorization Candidates must be authorized to work in the United States without current or future employer sponsorship. Equal Employment Opportunity Pivotal Health is an Equal Opportunity Employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. We do not discriminate on the basis of race, color, religion, sex, gender identity or expression, sexual orientation, national origin, age, disability, veteran status, or any other legally protected status. Reasonable Accommodations Pivotal Health provides reasonable accommodations for qualified individuals with disabilities in accordance with applicable laws. If you need assistance during the application or interview process, please let us know. Background Checks Employment is contingent upon successful completion of applicable background checks, where permitted by law. At-Will Employment Employment with Pivotal Health is at-will and may be terminated by either party at any time, with or without cause or notice, in accordance with applicable law.

Lead architecture and development of ERP and Salesforce integrations with scalable financial systems. | 7+ years backend software engineering with architectural ownership and financial/payment systems experience. | About Pivotal Health Pivotal Health is the leading technology platform that helps healthcare providers get paid fairly in an increasingly complex reimbursement landscape. Today, many providers face persistent underpayment from health insurance companies, despite delivering high-quality care. While processes like IDR (Independent Dispute Resolution) were designed to promote fairness, they’re often administrative-heavy, time-consuming, and difficult to navigate without the right tools. Pivotal Health combines software, data, and service into a seamlessly integrated, AI-driven platform that simplifies these complex reimbursement workflows. We help providers efficiently dispute underpaid claims, reduce administrative burden, and recover the reimbursement they’re entitled to; without adding more work to already stretched teams. Our full-service IDR solution is just the starting point. We’re building solutions that enable providers to operate with clarity, control, and confidence across the reimbursement journey. About the Role We're hiring a Staff Software Engineer to join Pivotal's brand new Systems Integration team, a small, technical group focused on how money moves through our platform and into the hands of the providers we serve. This is a greenfield role with real architectural ownership: you'll be building integrations from scratch, making foundational technical decisions, and setting the patterns the team will build on for years to come. If you want to work on a hard problem with a strong team, real ownership, and room to grow, this is it. What You'll do Lead the architecture and build of greenfield integrations: Design and implement our ERP and Salesforce integrations from the ground up. You'll make the foundational architectural decisions, evaluate tradeoffs, and document the reasoning behind them, building systems that are scalable, maintainable, and fit for a fast-growing platform. Own the technical direction for money movement logic: Build the business logic that determines how funds are calculated and distributed: how much goes to the client, how much flows through the IDR system, and how refunds are handled after billing. This is core infrastructure with direct financial impact. Drive technical decision-making and documentation: As a technical leader on a small team, you'll be expected to define standards, write supporting documentation, and ensure the team's technical decisions are clearly reasoned and well-recorded. You set the bar for how the team builds. Stay hands-on: This is not an ivory tower architecture role. You'll be writing production code, reviewing your team's work, and staying close to the implementation throughout the project lifecycle. Grow with the team: Staff Engineers are expected to be tech leads of their respective project workstreams. You'll have the opportunity to shape not just the codebase, but the team structure itself. Who you are 7+ years of software engineering experience with a strong backend focus Proven track record of owning architectural decisions on complex, production systems Experience building integrations with third-party platforms: ERPs, CRMs, financial systems, or similar Strong understanding of financial or payments systems: you understand how money moves and what correctness means in that context Experience with transactional systems and distributed architecture is a plus. Comfortable in greenfield environments: you can operate without established playbooks and make sound decisions in ambiguity Self-directed and highly communicative: on a small team, you don't wait to be told what to do next Startup or early-stage experience: you understand what it means to build in an environment where organizational infrastructure is still taking shape Extra credit if you have Direct experience with Salesforce or ERP integrations (e.g., NetSuite, Sage, QuickBooks) Background in FinTech, payments, or billing systems Experience growing into or functioning as a tech lead on a small, fast-moving engineering team Why You’ll Love Working Here We’re a collaborative, low-ego team on a mission to make healthcare reimbursement fairer for providers. While we primarily hire around our core hubs–Los Angeles and New York–we remain open to exceptional talent outside those regions. Remote and hybrid flexibility varies by role and team, and is outlined in each job description. If you’re excited by solving complex problems and making a real-world impact, we’d love to hear from you. Benefits Include: Competitive compensation, including equity Full health, dental, and vision coverage Retirement savings plan through 401(k) Flexible time off Opportunities for company-wide connection and events Ready to Make an Impact? We’re building something meaningful; and we want you on the team. Bring your ideas, curiosity, and drive, and let’s transform healthcare reimbursement together. Employment Information Work Authorization Candidates must be authorized to work in the United States without current or future employer sponsorship. Equal Employment Opportunity Pivotal Health is an Equal Opportunity Employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. We do not discriminate on the basis of race, color, religion, sex, gender identity or expression, sexual orientation, national origin, age, disability, veteran status, or any other legally protected status. Reasonable Accommodations Pivotal Health provides reasonable accommodations for qualified individuals with disabilities in accordance with applicable laws. If you need assistance during the application or interview process, please let us know. Background Checks Employment is contingent upon successful completion of applicable background checks, where permitted by law. At-Will Employment Employment with Pivotal Health is at-will and may be terminated by either party at any time, with or without cause or notice, in accordance with applicable law.

Build new product experiences focusing on backend services, APIs, and AI-enabled workflows in collaboration with cross-functional teams. | Strong product-minded software engineer with backend-leaning full stack background, Python and React experience, and AI power user in a startup environment. | About Pivotal Health Pivotal Health is the leading technology platform that helps healthcare providers get paid fairly in an increasingly complex reimbursement landscape. Today, many providers face persistent underpayment from health insurance companies, despite delivering high-quality care. While processes like IDR (Independent Dispute Resolution) were designed to promote fairness, they’re often administrative-heavy, time-consuming, and difficult to navigate without the right tools. Pivotal Health combines software, data, and service into a seamlessly integrated, AI-driven platform that simplifies these complex reimbursement workflows. We help providers efficiently dispute underpaid claims, reduce administrative burden, and recover the reimbursement they’re entitled to; without adding more work to already stretched teams. Our full-service IDR solution is just the starting point. We’re building solutions that enable providers to operate with clarity, control, and confidence across the reimbursement journey. About the Role We’re hiring a Staff Software Engineer to help build new products at Pivotal from the ground up. This role sits on the AI/ML Engineering team. You’ll work on new product surfaces that combine software, data, workflow design, and AI to solve high-value customer problems. The role is full stack, but intentionally backend-leaning. We’re looking for someone who is comfortable owning product behavior end to end while being especially strong in APIs, backend systems, data flows, and the logic that makes great products actually work. This is a high-ambiguity, high-velocity role. You will not be handed perfectly scoped tickets or asked to maintain a mature product in a narrow lane. You’ll help shape what we build, how we build it, and how quickly we can turn ideas into valuable product experiences. The upside is massive impact: the products you work on can materially change how the company operates and how customers experience Pivotal. We also want someone who is AI-first in how they work. Part of this team’s job is building AI-powered products, but part of it is also helping the company get dramatically better at using AI. We want a product engineer who is personally fluent with AI tools and can use them to move faster, think better, and build stronger products. What You’ll Do Build new product experiences from 0 to 1 across backend services, APIs, integrations, and frontend workflows. Design and implement backend systems that power product logic, orchestration, data access, and AI-enabled workflows. Contribute to frontend product development in React-based applications, especially where product quality depends on tight frontend-backend iteration. Work closely with product, design, operations, and AI/ML partners to turn ambiguous ideas into shipped product. Prototype quickly, then harden what works into maintainable product systems. Build internal and customer-facing workflows that use AI, structured data, and software automation to increase leverage. Help define product requirements through direct technical judgment, not just implementation after decisions are made. Improve product quality through instrumentation, testing, thoughtful system design, and strong engineering hygiene. Use AI actively in your own workflow for coding, debugging, investigation, product exploration, and iteration. Raise the team’s velocity by bringing AI-native working habits, practical engineering judgment, and strong product instincts. What Success Looks Like In the first 6 to 12 months, strong outcomes in this role would include: shipping meaningful new product capabilities quickly taking ownership of backend-heavy product surfaces with minimal oversight helping turn vague opportunities into real shipped workflows improving product quality and speed through strong engineering execution contributing to a team culture that is highly effective at using AI to build and learn faster becoming a trusted technical partner to product, design, and operations in a fast-moving environment Who You Are You are a strong product-minded software engineer who likes building things that users feel directly. You are full stack, but your center of gravity is backend systems and product logic. You are comfortable moving quickly in ambiguous environments and can make good decisions without waiting for perfect clarity. You have a high ownership mindset and like driving work from rough idea to production. You care about product quality, not just technical elegance. You are an AI power user yourself. You actively use AI in your day-to-day work and have strong judgment about how it can accelerate engineering and product development. You communicate clearly and work well with cross-functional partners. You want to be in an environment where a great engineer can have outsized impact very quickly. We’d Be Especially Excited If You Have strong backend experience in Python, FastAPI, or similar service-oriented systems experience building product backends, APIs, integrations, and data-heavy application logic experience contributing meaningfully to modern React-based frontend applications experience with TypeScript, React Router or Remix-style frameworks, and product UI development experience with PostgreSQL, SQLAlchemy, or other relational data systems experience with GCP or similar cloud environments experience building AI-powered products, internal tools, workflow software, or operational software experience in fast-moving startup environments where engineers help define the product, not just implement it experience in healthcare, fintech, logistics, or other operationally complex domains Why This Role Is Interesting You’ll work on new products, not just incremental maintenance. The problems are meaningful, messy, and important. They sit close to real customer and business pain. You’ll have real room to shape direction. This is a role for someone who wants to help create, not just execute. The team sits at the intersection of AI, product, data, and operations, which creates unusual leverage for strong engineers. The pace is fast, the ambiguity is real, and the impact can be massive. You’ll be able to use both sides of your skill set: deep backend engineering and pragmatic full stack product development. Example Technical Environment Our current environment includes technologies like: Python and FastAPI on the backend PostgreSQL and relational data models React-based web applications with modern routing and TypeScript GCP-hosted services and internal APIs AI and workflow systems that combine application logic, structured data, and model-backed experiences You do not need to match this stack perfectly, but you should be comfortable learning quickly and shipping in this kind of environment. Why You’ll Love Working Here We’re a collaborative, low-ego team on a mission to make healthcare reimbursement fairer for providers. While we primarily hire around our core hubs–Los Angeles and New York–we remain open to exceptional talent outside those regions. Remote and hybrid flexibility varies by role and team, and is outlined in each job description. If you’re excited by solving complex problems and making a real-world impact, we’d love to hear from you. Benefits Include: Competitive compensation, including equity Full health, dental, and vision coverage Retirement savings plan through 401(k) Flexible time off Opportunities for company-wide connection and events Ready to Make an Impact? We’re building something meaningful; and we want you on the team. Bring your ideas, curiosity, and drive, and let’s transform healthcare reimbursement together. Employment Information Work Authorization Candidates must be authorized to work in the United States without current or future employer sponsorship. Equal Employment Opportunity Pivotal Health is an Equal Opportunity Employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. We do not discriminate on the basis of race, color, religion, sex, gender identity or expression, sexual orientation, national origin, age, disability, veteran status, or any other legally protected status. Reasonable Accommodations Pivotal Health provides reasonable accommodations for qualified individuals with disabilities in accordance with applicable laws. If you need assistance during the application or interview process, please let us know. Background Checks Employment is contingent upon successful completion of applicable background checks, where permitted by law. At-Will Employment Employment with Pivotal Health is at-will and may be terminated by either party at any time, with or without cause or notice, in accordance with applicable law.

Design and implement backend-heavy full stack product features integrating AI and data workflows in a fast-paced, ambiguous environment. | Senior software engineer with strong backend and API skills, comfortable with full stack development, AI tools, and rapid product iteration in a startup-like setting. | About Pivotal Health Pivotal Health is the leading technology platform that helps healthcare providers get paid fairly in an increasingly complex reimbursement landscape. Today, many providers face persistent underpayment from health insurance companies, despite delivering high-quality care. While processes like IDR (Independent Dispute Resolution) were designed to promote fairness, they’re often administrative-heavy, time-consuming, and difficult to navigate without the right tools. Pivotal Health combines software, data, and service into a seamlessly integrated, AI-driven platform that simplifies these complex reimbursement workflows. We help providers efficiently dispute underpaid claims, reduce administrative burden, and recover the reimbursement they’re entitled to; without adding more work to already stretched teams. Our full-service IDR solution is just the starting point. We’re building solutions that enable providers to operate with clarity, control, and confidence across the reimbursement journey. About the Role We’re hiring a Staff Software Engineer to help build new products at Pivotal from the ground up. This role sits on the AI/ML Engineering team. You’ll work on new product surfaces that combine software, data, workflow design, and AI to solve high-value customer problems. The role is full stack, but intentionally backend-leaning. We’re looking for someone who is comfortable owning product behavior end to end while being especially strong in APIs, backend systems, data flows, and the logic that makes great products actually work. This is a high-ambiguity, high-velocity role. You will not be handed perfectly scoped tickets or asked to maintain a mature product in a narrow lane. You’ll help shape what we build, how we build it, and how quickly we can turn ideas into valuable product experiences. The upside is massive impact: the products you work on can materially change how the company operates and how customers experience Pivotal. We also want someone who is AI-first in how they work. Part of this team’s job is building AI-powered products, but part of it is also helping the company get dramatically better at using AI. We want a product engineer who is personally fluent with AI tools and can use them to move faster, think better, and build stronger products. What You’ll Do • Build new product experiences from 0 to 1 across backend services, APIs, integrations, and frontend workflows. • Design and implement backend systems that power product logic, orchestration, data access, and AI-enabled workflows. • Contribute to frontend product development in React-based applications, especially where product quality depends on tight frontend-backend iteration. • Work closely with product, design, operations, and AI/ML partners to turn ambiguous ideas into shipped product. • Prototype quickly, then harden what works into maintainable product systems. • Build internal and customer-facing workflows that use AI, structured data, and software automation to increase leverage. • Help define product requirements through direct technical judgment, not just implementation after decisions are made. • Improve product quality through instrumentation, testing, thoughtful system design, and strong engineering hygiene. • Use AI actively in your own workflow for coding, debugging, investigation, product exploration, and iteration. • Raise the team’s velocity by bringing AI-native working habits, practical engineering judgment, and strong product instincts. What Success Looks Like In the first 6 to 12 months, strong outcomes in this role would include: • shipping meaningful new product capabilities quickly • taking ownership of backend-heavy product surfaces with minimal oversight • helping turn vague opportunities into real shipped workflows • improving product quality and speed through strong engineering execution • contributing to a team culture that is highly effective at using AI to build and learn faster • becoming a trusted technical partner to product, design, and operations in a fast-moving environment Who You Are • You are a strong product-minded software engineer who likes building things that users feel directly. • You are full stack, but your center of gravity is backend systems and product logic. • You are comfortable moving quickly in ambiguous environments and can make good decisions without waiting for perfect clarity. • You have a high ownership mindset and like driving work from rough idea to production. • You care about product quality, not just technical elegance. • You are an AI power user yourself. You actively use AI in your day-to-day work and have strong judgment about how it can accelerate engineering and product development. • You communicate clearly and work well with cross-functional partners. • You want to be in an environment where a great engineer can have outsized impact very quickly. We’d Be Especially Excited If You Have • strong backend experience in Python, FastAPI, or similar service-oriented systems • experience building product backends, APIs, integrations, and data-heavy application logic • experience contributing meaningfully to modern React-based frontend applications • experience with TypeScript, React Router or Remix-style frameworks, and product UI development • experience with PostgreSQL, SQLAlchemy, or other relational data systems • experience with GCP or similar cloud environments • experience building AI-powered products, internal tools, workflow software, or operational software • experience in fast-moving startup environments where engineers help define the product, not just implement it • experience in healthcare, fintech, logistics, or other operationally complex domains Why This Role Is Interesting • You’ll work on new products, not just incremental maintenance. • The problems are meaningful, messy, and important. They sit close to real customer and business pain. • You’ll have real room to shape direction. This is a role for someone who wants to help create, not just execute. • The team sits at the intersection of AI, product, data, and operations, which creates unusual leverage for strong engineers. • The pace is fast, the ambiguity is real, and the impact can be massive. • You’ll be able to use both sides of your skill set: deep backend engineering and pragmatic full stack product development. Example Technical Environment Our current environment includes technologies like: • Python and FastAPI on the backend • PostgreSQL and relational data models • React-based web applications with modern routing and TypeScript • GCP-hosted services and internal APIs • AI and workflow systems that combine application logic, structured data, and model-backed experiences You do not need to match this stack perfectly, but you should be comfortable learning quickly and shipping in this kind of environment. Why You’ll Love Working Here We’re a collaborative, low-ego team on a mission to make healthcare reimbursement fairer for providers. While we primarily hire around our core hubs–Los Angeles and New York–we remain open to exceptional talent outside those regions. Remote and hybrid flexibility varies by role and team, and is outlined in each job description. If you’re excited by solving complex problems and making a real-world impact, we’d love to hear from you. Benefits Include: • Competitive compensation, including equity • Full health, dental, and vision coverage • Retirement savings plan through 401(k) • Flexible time off • Opportunities for company-wide connection and events Ready to Make an Impact? We’re building something meaningful; and we want you on the team. Bring your ideas, curiosity, and drive, and let’s transform healthcare reimbursement together. Employment Information Work Authorization Candidates must be authorized to work in the United States without current or future employer sponsorship. Equal Employment Opportunity Pivotal Health is an Equal Opportunity Employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. We do not discriminate on the basis of race, color, religion, sex, gender identity or expression, sexual orientation, national origin, age, disability, veteran status, or any other legally protected status. Reasonable Accommodations Pivotal Health provides reasonable accommodations for qualified individuals with disabilities in accordance with applicable laws. If you need assistance during the application or interview process, please let us know. Background Checks Employment is contingent upon successful completion of applicable background checks, where permitted by law. At-Will Employment Employment with Pivotal Health is at-will and may be terminated by either party at any time, with or without cause or notice, in accordance with applicable law.