Software Engineer II

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.

We’re looking for a Backend Software Engineer who loves solving problems, takes initiative, and thrives in an early-stage environment. You’ll work closely with product, operations, and frontend engineering to ship features end-to-end, improve reliability, and shape the systems that power our platform.

This role is perfect for someone who is naturally curious, comfortable asking questions, and unafraid to propose new approaches when something doesn’t feel quite right. You bring a low-ego, collaborative mindset, enjoy giving and receiving feedback, and care more about delivering value than debating the perfect implementation. If you like rolling up your sleeves, learning quickly, and influencing how a product grows, you’ll love it here!

• Ownership: Take initiative on features and improvements, collaborating with teammates to deliver reliable solutions.

• Momentum: Move fast, iterate wisely, and deliver meaningful results without sacrificing quality or reliability.

• Impact: Solve real problems that matter for our team and our users; focus on practical, scalable solutions that drive value.

• Innovation: Bring initiative and creativity to tackle challenging problems; propose new approaches and improvements that move the product forward.

• Collaboration: Work humbly and openly with teammates, leveraging others’ expertise while sharing your own; communicate clearly with both technical and non-technical partners.

• Transparency: Share context, challenges, and decisions openly—ask questions, surface risks early, and be comfortable giving and receiving feedback.

• Culture: Contribute to a healthy, low-ego team environment that values empathy, growth, and mutual respect, while fostering collaboration, learning, and knowledge-sharing

• Bachelor’s degree in STEM preferred (additional experience in lieu of a degree is also accepted.

• 4+ years of experience building backend or service-oriented systems.

• Experience with an OO backend language (Python, Go, Java, etc.); no prior Python production experience required.

• Strong understanding of software fundamentals, design patterns, and API development.

• Experience with relational databases (we use Postgre
  
  SQL).

• Comfortable working with cloud infrastructure (AWS or GCP), CI/CD, and modern development workflows.

Extra Credit If You Have

• Background in Fin Tech or Payments, especially with systems that handle scale or compliance

• Proficiency with Python in production environments

• Experience thriving in an early-stage or growth-stage startup

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…