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 looking for a Senior Platform Engineer to help design, scale, and harden the foundation that powers Pivotal’s platform.

This role is for engineers who enjoy thinking deeply about systems and can clearly articulate why a solution works, not just how to implement it. You’ll partner closely with engineering teams to evolve our cloud architecture, improve reliability and security, and ensure our platform scales as the business takes on more customers and more complexity.

You’ll help evolve our cloud architecture to better support scale, isolation, and long-term growth. You’ll partner closely with engineering teams to design secure, reliable event-driven systems. And you’ll build automation that removes friction so developers can ship faster and more confidently.

This is a high-impact role with meaningful ownership and influence over how our platform continues to mature.

What You’ll Do

• Design and evolve platform architecture: Help shape the architecture of our platform by evaluating trade-offs, improving system design, and partnering with teams to build scalable, reliable infrastructure that supports long-term growth.
  

• Build software that powers the platform: Develop tooling, services, and automation that improve developer productivity, reliability, and observability across the system.
  

• Own infrastructure as code and automation: Expand and harden our Terraform coverage, ensuring critical resources are versioned, auditable, and safely provisioned across environments.

• Design scalable, reliable system interactions: Contribute to the design of system interactions and data flows, making thoughtful architectural decisions that balance scalability, reliability, and performance as the platform evolves.
  

• Improve reliability and operational signal: Build and evolve monitoring, alerting, dashboards, and testing pipelines that surface meaningful signal rather than noise.
  

• Secure the platform and toolchain: Partner on securing CI/CD pipelines, access controls, networking, and data flows while supporting compliance efforts as we grow.
  

• Reduce toil and improve leverage: Identify repetitive or high-friction work and eliminate it through automation, better abstractions, or new tooling, including leveraging AI where it meaningfully helps.
  

• Partner with engineering teams: Operate as a partner to feature teams, helping unblock delivery, improve systems, and ensure platform decisions reflect real-world needs.

Who You Are

• 5+ years of experience in platform, infrastructure, or software engineering roles

• Bachelor’s degree in Computer Science, Engineering, or a related field preferred; equivalent practical experience will be considered.

• Strong software engineering foundation with solid coding skills; Python preferred.

• Hands-on experience designing and operating cloud-native systems (GCP preferred)

• Deep experience with Infrastructure as Code (Terraform)

• Experience building and maintaining CI/CD pipelines (GitHub, GitHub Actions)

• Strong understanding of containers, Docker, and cloud networking fundamentals, as well as orchestration platforms like Kubernetes

• Experience with databases and data infrastructure

• Familiarity with event-driven architectures (Kafka, Pub/Sub, Kinesis, or similar)

• Comfortable discussing architectural trade-offs and system design decisions clearly and thoughtfully

Extra Credit Experience

• Experience operating in startup or scaling environments

• Prior SRE experience or helping teams mature toward SRE practices

• Serverless or managed cloud architectures

• Experience in regulated or security-sensitive environments

• Building automation or AI-driven tooling to reduce operational toil

• Previous experience in FinTech, HealthTech or highly regulated industries.

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.