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.

Staff Software Engineer - Growth + Onboarding