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
The product platform is the layer other product teams build on. Today that means identity and access, including customer SSO, invitations, and sessions; the organization and tenancy model; the shared services, APIs, and schemas that carry customer data between products; and the developer experience, including the tooling and agent workflows engineers use to ship. The scope grows whenever product teams need a capability that should be built once. Role-based access control, email infrastructure, the production path for the models our products depend on, and likely data ingress are next in line. When this layer is right, product teams move faster and customers have a better experience.
This is a high-ownership, high-autonomy role on a team that is still defining itself. You'll have a direct say in how the platform, and the team, approach hard problems. We are still working out architecture, ownership boundaries, and integration patterns, so the right person operates without a playbook and brings strong technical judgment to ambiguous problems. You'll be a hands-on technical leader. You'll write production code, lead design reviews, and set the standards other engineers build to. The systems you own will be ones multiple teams depend on, and the engineers around you will get better and faster because you are there. Expect us to ask about a system you built: who used it, why they cared, and what you would have built differently had you understood that sooner.
WHAT YOU'LL DO
- Own the technical direction of the platform: Drive architectural decisions across identity and access, tenancy, shared services, developer experience, and each new platform area the company takes on. Set the standards the rest of the team builds to, and make ownership boundaries explicit where they are still fuzzy.
- Stay hands-on: Write production code, lead design reviews, and take end-to-end ownership of the systems you drive, especially the ones multiple teams depend on.
- Design for extension and reuse: Build composable abstractions and well-defined interfaces so product teams can extend the platform without forking it or waiting on you.
- Design scalable, reliable system interactions: Make the architectural calls on system interactions and data flows that balance scalability, reliability, security, and performance as the platform evolves.
- Translate ambiguity into executable plans: Partner with product and engineering leadership to turn loosely defined requirements into clear, well-scoped work with understood trade-offs.
- Raise the engineering bar: Establish patterns and practices, through code, reviews, and direct collaboration, that improve quality, reliability, and maintainability across product teams, including how engineers use AI tooling well.
- Mentor and grow engineers: Be a technical resource and thought partner for senior and mid-level engineers on the team and on the product teams you work with.
WHO YOU ARE
- 8+ years of software engineering experience with strong backend depth and the range to work across full-stack product surfaces and across domains, since this platform will span authorization, messaging, model operations, and data ingestion
- Track record of owning architectural decisions on complex production systems that multiple teams rely on, especially customer-facing or cross-functional ones
- Proficient in Python or able to demonstrate strong backend depth in a Python-based technical interview
- Strong hands-on experience designing and operating cloud-native systems; GCP preferred
- Experience with relational data modeling and schema evolution in systems where a wrong migration is expensive
- Strong product instincts: you judge a system by whether it is useful and correct, and elegance comes second
- Able to engage in customer and problem discovery: you bring curiosity and good questions, you carry what you learn into a technical plan, and you hold the team to building what customers actually need over what is most interesting to build
- Self-directed and communicative: you surface problems early and drive work forward without waiting for direction
- Comfortable in greenfield environments with evolving requirements and ambiguous ownership
- You lead by doing the work and making the case, without needing the title to do it
- Low-ego and collaborative by default: direct, open to feedback, and more interested in shipping great work than in being right
EXTRA CREDIT EXPERIENCE
- Authorization models (RBAC, ABAC, policy engines) that survived contact with real customers, or identity systems at production scale
- Building an internal developer platform, shared SDKs, or reusable application scaffolding that multiple teams adopted
- Shaping how a team uses AI tooling in its engineering workflow, with judgment about where it helps and where it does not
- TypeScript and React, enough to work across the products the platform serves
- Startup or early-stage experience where engineers helped decide what to build
- FinTech, HealthTech, or other regulated industries
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.