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Pivotal Health is hiring for a high-ownership platform role focused on identity, tenancy, and developer experience. You will own architectural decisions, write production code, and drive scalable systems while mentoring engineers across multiple teams.
We expect 8+ years of software engineering, strong backend depth in Python, and experience with cloud-native architectures. Remote or hybrid flexibility is available, with core hubs in major US regions.
Pivotal Health is the leading technology platform that helps healthcare providers get paid fairly in an increasingly complex reimbursement landscape.
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.
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.
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.
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.
Candidates must be authorized to work in the United States without current or future employer sponsorship.
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.
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.
Employment is contingent upon successful completion of applicable background checks, where permitted by law.
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: $220K - $250K