Senior Software Engineer

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 Senior Software Engineer to join Pivotal's Growth & Onboarding team. This is a primarily backend-focused role building the systems that power how new providers onboard to the platform, get configured, and start realizing value, a surface that directly shapes the customer experience and Pivotal's ability to scale.

You'll build practical, customer-facing tools and workflows tied to onboarding and growth, working closely not just with product and engineering but with sales and marketing stakeholders who depend on this team as a key touchpoint in the customer lifecycle. Strong product instincts and a genuine interest in what customers need earliest in their journey are just as important as technical depth here.

What You'll Do

• Build and own backend systems: Design, implement, and maintain the services and APIs that power provider onboarding, activation, customization workflows, and growth-oriented tooling. Take end-to-end ownership from design through production.

• Build practical customer-facing tools: Translate what providers, sales, and marketing need at the earliest stages of the customer lifecycle into reliable, well-designed backend systems and workflows.

• Contribute to architectural decisions: Be an active participant in technical planning and design discussions. Bring your implementation perspective and push back when you see a better path.

• Partner cross-functionally: Work closely with product, sales, and marketing stakeholders, not just engineering. This team is a key customer touchpoint and the right person is comfortable in that cross-functional environment.

• Operate with autonomy: With a small team and real ownership, there's no room for passengers. You'll identify what needs solving and drive your work forward without heavy oversight.

• Write reliable, maintainable code: Hold a high bar for code quality, testing, and system design. Build things that hold up as the platform and team scale.

• Surface problems early: Communicate blockers, risks, and open questions proactively. Keeping the team aligned is part of doing the job well.

Who You Are

• 5+ years of software engineering experience with a strong backend focus

• Solid understanding of backend fundamentals: system design, data modeling, API development, and service reliability

• Strong product orientation with good instincts around customer needs and usability: you think about the person using the thing, not just the system underneath it

• Python experience preferred; candidates from other backend languages are welcome if they're prepared to interview in Python and ramp quickly

• Comfortable working in product-driven environments with cross-functional stakeholders including sales and marketing

• Comfortable in greenfield environments with evolving requirements

• Self-directed and proactive: you identify problems and drive them to resolution

• Strong communicator who surfaces ambiguity early and collaborates well across functions

• Experience in early-stage or startup environments where engineers own outcomes, not just tasks

Extra Credit If You Have

• Experience building onboarding flows, activation funnels, customization tooling, or growth-oriented product features

• Familiarity with sales or marketing support tooling or benchmarking tools

• Familiarity with experimentation, feature flagging, or A/B testing

• Background in FinTech, HealthTech, or other regulated industries

• 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.