Jobs at Pivotal Health

Lead and build a standalone State Arbitration/IDR function: set strategy and priorities across ~20 states, formalize filing workflows, recover misrouted claims, manage and scale the operations team, and partner with Data, Product, and Engineering to deliver automation and tooling while owning remittance advice and eligibility judgment logic.

Design, scale, and harden the platform: evolve cloud architecture, build tooling and IaC (Terraform), improve reliability/observability, secure CI/CD and networks, automate developer workflows, and partner with engineering teams to support growth.

Serve as Pivotal's internal expert on the No Surprises Act and Federal IDR, manage relationships with IDREs, monitor regulatory developments, translate guidance into product/operational recommendations, represent the company in industry forums, and train/internal enable teams on IDR processes.

Own and improve backend case execution systems (eligibility, batching, submissions, orchestration). Solve complex, data-driven decision and workflow problems, collaborate cross-functionally, and support internal UI/admin tooling as needed.

Design, evaluate, and productionize decisioning systems that affect pricing, offers, and routing. Run experiments, build models/heuristics and optimization logic under operational constraints, create feedback loops linking model behavior to business outcomes, and partner with engineers to ship improvements. Use AI as an active tool and help the team adopt AI-native workflows.

Support Client Success by triaging payor compliance tickets, pulling and analyzing claims data, investigating payor-side blockers, conducting outreach, and building SOPs and client-facing materials to improve reimbursement outcomes.

Provide day-to-day end-user IT and SaaS support across Google Workspace and Microsoft PC/Mac environments; manage onboarding/offboarding and user access; troubleshoot hardware, software, networking, and AV/video-conferencing issues; maintain endpoint hardware and office networking; lead IT projects and coordinate timelines, priorities, and stakeholder communication.

Design, build, deploy, and maintain production AI systems (LLM-powered and agentic) to automate healthcare reimbursement workflows. Own end-to-end model development, evaluation, monitoring, and continuous improvement; collaborate with product, data, and operations to translate requirements into reliable, scalable systems while ensuring safety, observability, and compliance with healthcare data standards.

Back-end leaning full-stack engineer to build 0-to-1 product experiences: design backend systems, APIs, data flows, and AI-enabled workflows; contribute to React frontends; prototype rapidly and harden production systems while collaborating cross-functionally.

Serve as an internal consultant driving end-to-end strategy and operations projects: diagnose problems, map processes, recommend improvements, manage cross-functional execution, measure impact, and communicate results to leadership. Lead structured problem-solving, project planning, and stakeholder alignment while scaling early-stage business functions and operating as both advisor and hands-on executor.

Own day-to-day office operations and vendor management, support an office move, design scalable in-person and virtual employee programs, translate company culture into physical space, champion accessibility, manage budgets, build communication systems (FAQs, Slack, Notion), and partner with People, IT, Finance and leadership. On-site in Williamsburg, Brooklyn.

Lead and build the Growth & Onboarding engineering team as a hands-on manager. Own onboarding, customization, and benchmarking systems; write code, perform reviews, drive delivery, partner with product, sales, and marketing, establish team rituals and processes, and coach engineers to improve execution and product-facing experience.

Lead and build a new backend-focused Integrations team owning end-to-end connections to EHRs, billing systems, and partner APIs. Act as a player-coach: write code, drive delivery, participate in customer/partner discovery, partner with product, and establish team practices, hiring, and technical direction.

Lead and own architecture, build backend integrations and production data pipelines (EHRs, billing, SFTP, partner APIs), translate ambiguous requirements into plans, collaborate cross-functionally, mentor engineers, and drive integration standards and reliability.

Build and own backend services and APIs that power provider onboarding, activation, customization, and growth tooling. Design, implement, and maintain reliable, testable systems; contribute to architecture; partner with product, sales, and marketing; operate autonomously; and prioritize code quality, monitoring, and scalability to drive customer activation and growth.

Build and own backend services, pipelines, and APIs that integrate Pivotal's platform with external healthcare systems and billing tools. Handle messy clinical and financial data, contribute to architecture, work autonomously with product and stakeholders, ensure code quality, and drive integrations from design to production.

Lead design and build of greenfield ERP and Salesforce integrations, own money-movement and payment logic, make architectural decisions, write production backend code, document standards, and act as a hands-on technical lead shaping team and systems.

Design, scale, and harden the platform by evolving cloud architecture, building IaC and automation, improving reliability and observability, securing CI/CD and toolchains, and partnering with engineering teams to remove toil and enable scalable, event-driven systems.

Build and own end-to-end full-stack features for provider onboarding, customization, benchmarking, and sales/marketing tooling. Develop React UIs and backend APIs/data models (Python), collaborate cross-functionally with product, sales, and marketing, contribute to architecture, and deliver reliable, maintainable code in a fast-moving, greenfield startup environment.

Manage federal and state reimbursement dispute cases through IDR and arbitration: evaluate eligibility and documentation, track timelines and correspondence, maintain case records, research state regulations, respond to payor/IDR communications, and contribute to process improvements.