Jobs at Pivotal Health

Lead the Case Strategy Engineering team, owning data models, databases, APIs, services, and full-stack workflows supporting AI- and ML-driven healthcare reimbursement strategies. Partner with Data Science and AI Platform teams to productionize models, build feedback systems, guide architecture, connect engineering outcomes to customer lift and ARR, and grow an experienced engineering organization.

Own and operate product platform services, libraries, schemas, APIs, and developer tooling. Design scalable, reliable, secure system interactions; improve monitoring, testing, and operational signal; reduce engineering toil through reusable abstractions and automation; and partner with product, data, and infrastructure teams. The role spans identity, access, shared services, data flows, messaging, and cloud-native systems in a greenfield environment.

Build and own backend-focused case execution systems covering eligibility, batching, submissions, operational workflows, and claim orchestration. Solve complex data-driven decision logic, improve workflow reliability, collaborate across engineering and product teams, and contribute to React-based internal tools and administrative workflows. The role requires strong Python experience, fullstack engineering fundamentals, and ownership in a fast-moving startup environment.

Own strategic financial analyses, build models for products, pricing, investments, and partnerships, analyze operational and financial data, and support forecasting, planning, investor materials, capital raises, and strategic initiatives. Partner cross-functionally to improve decision-making infrastructure and translate business drivers into actionable recommendations.

Manage accounts payable, payroll processing, company credit cards, employee reimbursements, benefit-plan administration, month-end close support, and cash management. The role will help transition payroll and benefits from a PEO to Rippling, ensure accurate tax and compliance filings, partner with People Operations, and support daily accounting operations in a fast-paced startup environment.

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.

Own the technical direction and architecture of a shared product platform spanning identity, access, tenancy, APIs, developer tooling, and data services. Write production code, lead design reviews, establish scalable and reliable engineering practices, translate ambiguous requirements into executable plans, and mentor engineers across teams. The role requires strong backend expertise, cloud-native systems experience, product judgment, and comfort working autonomously in a greenfield environment.

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.

Define reliability strategy and technical roadmaps; design scalable cloud infrastructure; improve observability, incident response, disaster recovery, automation, and deployment systems. Partner across engineering, security, data, AI, and product teams to strengthen resilience, compliance, and operational excellence. Lead architecture reviews, resolve complex production issues, establish SRE practices, and mentor engineers while reducing operational toil and improving platform scalability.

Lead the evolution of Pivotal Health’s data infrastructure and engineering team. Own architecture across ingestion, processing, storage, and data consumption; build scalable streaming and batch platforms, APIs, observability, security controls, and privacy guardrails. Hire and mentor software engineers, promote testing, CI/CD, IaC, version control, and code quality, and enable product, AI, and business intelligence teams to manage schemas and consume reliable data services.

Lead and build Pivotal Health's security program: set strategy, embed secure-by-design practices with engineering, own SOC 2/HIPAA compliance and audits, monitor threats, represent security to customers and auditors, drive companywide security culture, and define AI/LLM guardrails.

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.

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.

Own strategic enterprise health system accounts, driving retention, expansion, and long-term partnerships. Advise revenue cycle executives, guide clients through No Surprises Act and IDR workflows, lead account planning and QBRs, resolve complex issues, and translate account analytics into recommendations. Build scalable client success playbooks and frameworks, synthesize client feedback for internal teams, and influence Product, Engineering, Operations, and Sales without direct reports.

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.

Sell Pivotal Health's reimbursement and IDR platform to hospitals and health systems across the Midwest. Generate pipeline with CFOs and revenue cycle leaders, manage complex multi-stakeholder sales cycles, own account strategy and forecasting, support negotiations and contracting, maintain executive relationships, partner with Customer Success for onboarding and expansion, and improve sales motion and CRM hygiene (Salesforce).