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 Staff Data Scientist, Decisioning to improve the systems that determine how Pivotal makes high-value decisions in core workflows.

This role is for someone with a strong applied data science or optimization background who wants to work on real production systems, not just offline analysis. You’ll operate at the intersection of data, experimentation, modeling, economics, and software. The work may span areas like the offer engine, feedback loops for model and rule improvements, configurable decision systems, experimentation on operational workflows, and other products where better decision quality directly improves business outcomes.

We’re especially interested in candidates who have worked on hard decisioning problems in environments like marketplaces, pricing and revenue optimization, lending and credit, ad tech, bidding systems, or other domains where experimentation, optimization, and operating constraints all matter at once.

This is not a research-only role. We want someone who can think deeply, work rigorously, and still move quickly from analysis and modeling into production changes with measurable impact.

We also want someone who is AI-first in their own workflow. The right person will use AI actively for exploration, analysis, iteration, experimentation, and engineering support, and will help the team build a strong AI-native way of working.

What You’ll Do

• Improve decisioning systems that affect pricing, offer behavior, workflow routing, and other economically meaningful product outcomes.

• Design and run experiments that help us understand whether product, rules, prompt, or model changes are actually improving performance.

• Build models, heuristics, optimization logic, or evaluation frameworks that improve real-world outcomes under operational constraints.

• Help translate business objectives into measurable decisioning systems with clear tradeoffs and success criteria.

• Work closely with engineers to productionize new logic rather than stopping at notebooks or offline recommendations.

• Help design feedback loops that connect model and workflow behavior back to product and business outcomes.

• Contribute to configurable rules systems and other controls that make decisioning easier to manage and improve over time.

• Use AI as a force multiplier in your own workflow and help the team move faster by bringing strong AI-native habits.

• Balance rigor and speed in an environment where shipping matters and iteration is constant.

What Success Looks Like

In the first 6 to 12 months, strong outcomes in this role would include:

• meaningful improvements to the offer engine or related decision systems

• high-quality experiments that clarify which changes actually improve outcomes

• stronger feedback loops between model behavior, rule behavior, and business performance

• better visibility into tradeoffs across quality, economics, operational cost, and user outcomes

• becoming a trusted owner of an important decisioning surface

• helping raise the team’s bar on experimentation, analytical rigor, and evidence-based iteration

Who You Are

• You are excited by high-stakes decisioning problems that combine data, uncertainty, incentives, and operational constraints.

• You have strong applied data science instincts, but you want your work to ship.

• You are comfortable moving between modeling, experimentation, analysis, and product or engineering collaboration.

• You can reason clearly about metrics, tradeoffs, and second-order effects.

• You are pragmatic and can choose the right level of sophistication for the problem instead of overcomplicating it.

• You are an AI power user yourself and actively use AI in your day-to-day work with good judgment.

• You like operating in fast-moving environments where the path is not perfectly defined and impact comes from good judgment plus speed.

We’d Be Especially Excited If You Have

• experience in pricing, revenue optimization, marketplace ranking, matching, bidding, lending, credit, underwriting, or ad tech systems

• experience designing and interpreting experiments in production environments

• experience with optimization, decisioning, forecasting, or applied statistics in high-leverage product systems

• experience partnering tightly with engineers to productionize models, logic, or recommendations

• experience with Python and backend-adjacent technical workflows

• experience turning messy business problems into measurable systems with clear operating tradeoffs

• experience in healthcare or other operationally complex industries

Why This Role Is Interesting

• The problems are economically meaningful and close to core company outcomes.

• The work combines data science depth with real product and production ownership.

• You’ll have room to shape the next generation of decisioning systems at a company where these systems matter.

• This is the kind of role where strong thinking can translate into clear business leverage quickly.

• We care about rigor, but we also care about shipping.

• Candidates from marketplaces, lending, pricing, and optimization teams often do especially well in this kind of environment because they are used to balancing models, metrics, and operational realities.

Example Technical Environment

Our current environment includes technologies and patterns like:

• Python-based services and internal ML tooling

• model evaluation and experimentation workflows

• configurable rules and decisioning systems

• production APIs and operational workflows

• AI and model-backed systems grounded in structured internal data

You do not need to match this stack perfectly, but you should be comfortable learning quickly and shipping in this kind of environment.

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.