Staff Software Engineer, New Products

Pivotal Health; New York (NY); Hybrid; USD 210,000 - 235,000; Full time

Benefits offered by this job

Competitive compensation and equity

Full health, dental, and vision

401(k) retirement savings plan

Flexible time off

Company-wide events

Job summary

Pivotal Health is seeking a senior engineer to help build and scale our IDR platform. You will own backend services, APIs, data pipelines, and AI-driven workflows, delivering production-grade features end-to-end.

You will work closely with customers, product leadership, and engineering to iterate rapidly, apply AI where it adds value, and help shape technical direction across teams. This role supports hybrid work from our New York hub with US-wide impact.

Qualifications

• 8+ years producing production software.
• Backend-focused with Python and PostgreSQL.
• Full product experience from idea to finished feature.
• Experience with LLMs and AI tooling.
• Customer-facing with ability to iterate from feedback.

Responsibilities

• Join customer calls and site visits to gather feedback and prototype rapidly.
• Build new products across backend services, APIs, data pipelines, AI-driven workflows, and front ends.
• Design experiments with the pod, instrument, and evaluate results.
• Guide technical direction with co-founder and Director of Product Engineering.
• Transition prototypes to production systems for cross-team maintenance.
• Set architectural direction and reusable building blocks for new ideas.
• Leverage AI tools to build, debug, and explore with the team.
• Collaborate with platform, data, and operations teams to reuse existing assets.

Skills

Backend development

Python

PostgreSQL

React

TypeScript

LLMs usage

Decision making

Tools

GCP

SQLAlchemy

React Router/Remix

Job description

About Pivotal Health

Pivotal Health is the leading technology platform that helps healthcare providers get paid fairly in an increasingly complex reimbursement landscape.

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 pod runs on short loops. You'll hear a problem on a customer call, have a prototype in that customer's hands within a week or two, and then use what they do with it to decide what's next. Some ideas will turn into products. Many won't, and dropping those quickly counts as a good result. You'll help make those calls as a peer, not just carry them out.

You’ll have more help than a typical zero-to-one engineer. You can build on our production IDR platform, years of reimbursement data, shared AI tooling, and operations experts who know our customers' workflows in detail. When something works, you'll have a clear path to scale it with the broader engineering org instead of carrying it alone.

What You'll Do

• Join customer calls and site visits, and turn what you hear into working prototypes, often in the same week.
• Build new products from zero to one across backend services, APIs, data pipelines, AI-driven workflows, and React front ends.
• Design each experiment with the pod: decide what a prototype needs to prove, instrument it, and read the results honestly.
• Decide with the co-founder and Director of Product Engineering when to push forward, change direction, or stop, and bring a strong technical point of view to those decisions.
• Take what works from prototype to a production system that the rest of engineering can run and extend.
• Set technical direction for new products: architecture, reusable building blocks, and standards that make each new idea faster to start than the last.
• Use AI tools as a core part of how you build, debug, and explore, and help the rest of engineering get better at it.
• Work with our core platform, data, and operations teams to reuse what already exists instead of rebuilding it.

Who You Are

• You’ve built and shipped production software for 8+ years, including time building new products from scratch at a startup or on a new-product team.
• You’re strong on the backend. You know Python (FastAPI or similar) or another modern service language, plus relational databases like PostgreSQL.
• You can ship a full product experience on your own. You know enough React and TypeScript to go from idea to finished feature without waiting on anyone.
• You learn from customers. You’ve worked directly with users and changed direction based on what you heard.
• You’ve built with large language models (LLMs) and have good judgment about where they help and where they don’t.
• You make decisions without perfect information. You’re comfortable choosing with what you have, and you revisit those choices when the evidence changes.

Extra Credit if you have

• Experience as an early or founding engineer.
• Background in healthcare revenue cycle or another operationally complex field (insurance, fintech, logistics).
• Familiarity with our stack: GCP, SQLAlchemy, and React Router/Remix.
• Experience with product analytics and experiment design.
• Experience building workflow software or internal tools for operations teams.

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.

Compensation Range: $210K - $235K