- Design and implement backend systems that power product logic, orchestration, data access, and AI-enabled workflows.
- Build internal and customer-facing workflows that use AI, structured data, and software automation to increase leverage.
Requirements
Pivotal Health combines software, data, and service into a seamlessly integrated, AI-driven platform that simplifies these complex reimbursement workflows.
This role sits on the AI/ML Engineering team.
You’ll work on new product surfaces that combine software, data, workflow design, and AI to solve high-value customer problems.
We also want someone who is AI-first in how they work.
Part of this team’s job is building AI-powered products, but part of it is also helping the company get dramatically better at using AI.
We want a product engineer who is personally fluent with AI tools and can use them to move faster, think better, and build stronger products.
WHAT YOU’LL DO - Build new product experiences from 0 to 1 across backend services, APIs, integrations, and frontend workflows.
- Work closely with product, design, operations, and AI/ML partners to turn ambiguous ideas into shipped product.
requirements through direct technical judgment, not just implementation after decisions are made. - Improve product quality through instrumentation, testing, thoughtful system design, and strong engineering hygiene. - Use AI actively in your own workflow for coding, debugging, investigation, product exploration, and iteration. - Raise the team’s velocity by bringing AI-native working habits, practical engineering judgment, and strong product instincts.
WHAT SUCCESS LOOKS LIKE In the first 6 to 12 months, strong outcomes in this role would include: - shipping meaningful new product capabilities quickly - taking ownership of backend-heavy product surfaces with minimal oversight - helping turn vague opportunities into real shipped workflows - improving product quality and speed through strong engineering execution - contributing to a team culture that is highly effective at using AI to build and learn faster - becoming a trusted technical partner to
- You are an AI power user yourself.
You actively use AI in your day-to-day work and have strong judgment about how it can accelerate engineering and product development. - You communicate clearly and work well with cross-functional partners. - You want to be in an environment where a great engineer can have outsized impact very quickly.
experience in Python, FastAPI, or similar service-oriented systems -
experience contributing meaningfully to modern React-based frontend applications -
experience with TypeScript, React Router or Remix-style frameworks, and product UI development -
experience with PostgreSQL, SQLAlchemy, or other relational data systems -
experience with GCP or similar cloud environments -
experience building AI-powered products, internal tools, workflow software, or operational software -
experience in fast-moving startup environments where engineers help define the product, not just implement it -
experience in healthcare, fintech, logistics, or other operationally complex domains WHY THIS ROLE IS INTERESTING - You’ll work on new products, not just incremental maintenance. - The problems are meaningful, messy, and important.
This is a role for someone who wants to help create, not just execute. - The team sits at the intersection of AI, product, data, and operations, which creates unusual leverage for strong engineers. - The pace is fast, the ambiguity is real, and the impact can be massive. - You’ll be able to use both sides of your skill set: deep backend engineering and pragmatic full stack product development.
EXAMPLE TECHNICAL ENVIRONMENT Our current environment includes technologies like: - Python and FastAPI on the backend - PostgreSQL and relational data models - React-based web applications with modern routing and TypeScript - GCP-hosted services and internal APIs - AI and workflow systems that combine application logic, structured data, and model-backed experiences You do not need to match this stack perfectly, but you should be comfortable learning quickly and shipping in this kind of environment.
Benefits
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.
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.
Equal Employment Opportunity Pivotal Health is an Equal Opportunity Employer.
Additional details
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.
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 help build new products at Pivotal from the ground up.
The role is full stack, but intentionally backend-leaning.
We’re looking for someone who is comfortable owning product behavior end to end while being especially strong in APIs, backend systems, data flows, and the logic that makes great products actually work.
You will not be handed perfectly scoped tickets or asked to maintain a mature product in a narrow lane.
You’ll help shape what we build, how we build it, and how quickly we can turn ideas into valuable product experiences.
The upside is massive impact: the products you work on can materially change how the company operates and how customers experience Pivotal.