Engineering Manager

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 hands-on Engineering Manager to lead a high impact team building the core systems behind our healthcare platform. This role is ideal for a product-minded engineering leader who enjoys partnering closely with Product to shape solutions, translate strategy into technical direction / execution, and ensure the team delivers consistently and sustainably with scalability in mind.

This is a true player-coach role. You will write code, drive delivery, and raise the bar for engineering quality today - while also developing the team and establishing a strong product-engineering mindset as we scale. If you enjoy balancing technical depth with leadership - and want to help define how an engineering organization grows - this role is for you.

What You'll Do

• Lead as a player-coach: Contribute code, perform design reviews and PRs, and guide technical strategy and decisions while supporting the growth and effectiveness of the team.
• Partner deeply with Product: Collaborate closely with Product to gather requirements, clarify scope, and translate product vision into executable technical plans. Help shape solutions early rather than reacting late.
• Drive execution and delivery: Own the engineering side of delivery by guiding sprint planning, standups, retrospectives, and prioritization - ensuring the team is constantly shipping and learning from each cycle.
• Translate ambiguity into clarity: Take loosely defined problems and help the team break them down into clear, achievable work with well-understood tradeoffs and success criteria.
• Provide technical direction: Make pragmatic system design and architectural decisions that balance speed, quality, and scalability.
• Build lightweight process and rituals: Establish and evolve team workflows (planning, estimation, retros, incident follow-ups) that improve focus and predictability without unnecessary ceremony.
• Support and grow engineers: Coach engineers on execution, communication, and ownership, helping develop careers both on the IC and Managerial tracks.
• Model strong engineering culture: Set the tone for empathy, accountability, and collaborative problem-solving across engineering and cross-functional partners.

Who You Are

• Bachelor's degree in STEM preferred (additional experience in lieu of a degree is also accepted)
• 6+ years of professional software engineering experience, including recent hands-on backend work
• 2+ years of experience managing and developing Engineers
• Experience working in product-driven environments with close Product partnership
• Comfortable gathering requirements, asking clarifying questions, and shaping solutions collaboratively
• Experience leading teams through agile delivery practices (planning, standups, retros)
• Strong technical judgment with a bias toward pragmatic, shippable solutions
• Able to balance near-term delivery with longer-term technical health
• Clear communicator who builds trust across Engineering, Product, and Design
• Thrives in early-stage or scaling environments where structure is evolving

Extra Credit Experience

• Experience at a Series A or early-stage startup, where priorities evolve quickly and leaders wear multiple hats
• Background in Fin Tech, healthcare, or another highly regulated industry, with an appreciation for security, privacy, and compliance constraints

Why You'll Love the Role

• Product impact: You'll help turn product vision into shipped, real-world outcomes.
• Hands-on leadership: Stay close to the code while growing your leadership scope.
• Team influence: Help shape how engineering and product work together as we scale.
• Growth runway: Opportunity to grow into a broader leadership role as the org matures.

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…