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.

Summary

Pivotal Health is looking for a Senior Applied AI/ML Engineer to build and improve high-impact AI systems that sit directly in our most important product and operational workflows. Reporting to the Head of AI/ML Engineering, you will be a key driver in how we use generative AI and intelligence to transform healthcare reimbursement, with a heavy, hands-on focus on building state-of-the-art models.

You will operate at the intersection of generative models, software, product workflows, and business outcomes. Your work will span critical areas such as document generation, dynamic offer engines, and next-generation decisioning systems, where your technical contributions will directly impact our most critical business KPIs. This role requires product-oriented applied engineering—the ability to take ambiguous opportunities and turn them into robust, shipped systems that create measurable value.

This is a role for an engineer who wants to build applied systems, not conduct research in isolation. We are looking for someone who is AI-first in their own work, eager to help our team establish a strong, AI-native way of working, and committed to developing the robust evaluation frameworks (evals) necessary to ensure our systems are production-ready. If you thrive on moving from a rough opportunity to concrete execution quickly, you will love working here.

What You’ll Do

Own and improve hands-on applied AI and ML systems that influence our most critical business KPIs and workflows.
Build and refine production workflows around generative AI models, including decisioning, retrieval, and orchestration.
Design and run robust evaluation frameworks (evals) and experiments that improve model quality, workflow quality, and business outcomes.
Partner with product, operations, and engineering teammates to define success metrics and translate messy real-world problems into buildable systems.
Improve prompt, model, and workflow behavior through tight feedback loops and practical iteration.
Contribute to the engineering quality of these systems, including instrumentation, testing, rollout safety, and operational visibility.
Utilize AI as a force multiplier in your own work and help the team move faster by bringing strong AI-native habits.

Who You Are

Experience with applied ML, LLM systems, agent workflows, or decisioning systems in production.
Experience designing and interpreting experiments, evals, or optimization loops.
Experience with Python and backend systems that support production AI workflows.
Experience turning messy operational data and product requirements into shipped systems.
Experience with healthcare or other operationally complex industries.
A product-oriented mindset with the ability to move from rough opportunity to concrete execution quickly.

Nice To Haves

Experience in domains like marketplaces, pricing, ad tech, credit decisioning, lending, or revenue optimization.
Experience with retrieval, prompt engineering, structured generation, model routing, or tool-using agent workflows.

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.

Senior Applied AI Engineer - Position Statements