Senior IT Systems Engineer

About the role:

We are looking for an engineer who can walk into messy, cross‑functional workflows and turn them into clean, automated systems that scale. This role focuses on identifying high‑friction operational processes across the company and replacing them with durable, API‑driven automation. You will work across IT, Security, Engineering, and Business teams to reduce manual work, improve reliability, and build systems that scale with the company.

This is not a ticket‑driven IT role. You will operate with a high degree of ownership, driving initiatives end‑to‑end from problem discovery through implementation and rollout. You will be part of the Business Technology - Corporate Engineering team and report to the Director of Business Technology.

This role will be based in our New York City office (in the Financial District). You must be willing to work in the office 3 days per week on Tuesday, Wednesday and Thursday.

• Identify and automate high‑impact operational workflows across onboarding, offboarding, access management, and service delivery
• Replace manual, fragmented processes with scalable, API‑driven systems
• Build and maintain integrations across HRIS, identity providers, SaaS platforms, and cloud environments
• Develop internal tools and automation using platforms like Retool, Okta Workflows, and custom scripts or services
• Apply infrastructure‑as‑code to manage and version system configurations
• Incorporate AI into workflows to improve efficiency in areas such as ticket routing, knowledge retrieval, and decision support
• Design and automate access and security workflows that enforce least‑privilege and auditability
• Own and drive cross‑functional initiatives end‑to‑end, from problem definition through implementation and rollout

• 4–7+ years of experience in IT, platform engineering, automation, or similar roles
• Strong scripting or programming ability in Python, Go, Node.js, Power Shell, or similar
• Experience building API‑driven automation across multiple systems
• Ability to design and implement workflows that span multiple tools and teams
• Experience with infrastructure‑as‑code such as Terraform or similar
• A desire to be part of a high‑performing, mission‑driven team that operates with intense urgency, a strong sense of individual accountability, and a commitment to authentic feedback

• Hands‑on experience with identity and access systems (Okta, SSO, SCIM, RBAC), including implementation and ongoing management
• Proven ability to build and scale internal tools using platforms like Retool or other low‑/no‑code solutions
• Familiarity with security automation and orchestration (e.g., Tines), with an eye toward reducing manual effort and risk
• Practical experience leveraging AI/LLMs to streamline and enhance operational workflows
• Strong understanding of compliance and security standards (HIPAA, SOC 2, HITRUST) and how they shape systems and processes
• Focused on driving meaningful outcomes
• Able to identify root‑cause, system‑level issues and design durable solutions rather than quick fixes
• Comfortable navigating cross‑functional environments with competing priorities and constraints
• Operates with urgency while building scalable, maintainable solutions
• Defaults to automation and efficiency wherever possible

• Okta, Okta Workflows, Retool, Fresh Service (ITSM), Google Workspace, Slack, Atlassian (Confluence and Jira), MDM platforms (Jamf Pro, Kandji/Iru, Intune), Airtable, AWS and GCP, Terraform, Rippling (HRIS), SOAR (Tines), and AI‑enabled operational tooling (Claude, Gemini, OpenAI)

The target salary range for this position is $153,000 - $190,000. Additional compensation includes equity incentive and competitive benefits plans, including flexible PTO, Medical/Dental/Vision plan options, 401(k), Teladoc Health and more.

We are unable to sponsor or take over sponsorship of an employment visa at this time.

Garner Health is proud to be an Equal Employment Opportunity employer and values diversity in the workplace. We do not discriminate based upon race, religion, color, national origin, sex (including pregnancy, childbirth, reproductive health decisions, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, genetic information, political views or activity, or other applicable legally protected characteristics.

Garner Health is committed to providing accommodations for qualified individuals with disabilities in our recruiting process. If you need assistance or an accommodation due to a disability, you may contact us at