Software Engineer, Products

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.

The pod runs on short loops. You'll hear a problem on a customer call, have a prototype in that customer's hands within a week or two, and then use what they do with it to decide what's next. Some ideas will turn into products. Many won't, and dropping those quickly counts as a good result. You'll help make those calls as a peer, not just carry them out.

You’ll have more help than a typical zero-to-one engineer. You can build on our production IDR platform, years of reimbursement data, shared AI tooling, and operations experts who know our customers' workflows in detail. When something works, you'll have a clear path to scale it with the broader engineering org instead of carrying it alone.

• Join customer calls and site visits, and turn what you hear into working prototypes, often in the same week.

• Build new products from zero to one across backend services, APIs, data pipelines, AI-driven workflows, and React front ends.

• Design each experiment with the pod: decide what a prototype needs to prove, instrument it, and read the results honestly.

• Decide with the co-founder and Director of Product Engineering when to push forward, change direction, or stop, and bring a strong technical point of view to those decisions.

• Take what works from prototype to a production system that the rest of engineering can run and extend.

• Set technical direction for new products: architecture, reusable building blocks, and standards that make each new idea faster to start than the last.

• Use AI tools as a core part of how you build, debug, and explore, and help the rest of engineering get better at it.

• Work with our core platform, data, and operations teams to reuse what already exists instead of rebuilding it.

• You’ve built and shipped production software for 8+ years
  , including time building new products from scratch at a startup or on a new-product team.

• You’re strong on the backend. You know Python (FastAPI or similar) or another modern service language, plus relational databases like PostgreSQL.

• You can ship a full product experience on your own. You know enough React and Type Script to go from idea to finished feature without waiting on anyone.

• You learn from customers. You’ve worked directly with users and changed direction based on what you heard.

• You’ve built with large language models (LLMs) and have good judgment about where they help and where they don’t.

• You make decisions without perfect information. You’re comfortable choosing with what you have, and you revisit those choices when the evidence changes.

• Experience as an early or founding engineer.

• Background in healthcare revenue cycle or another operationally complex field (insurance, fintech,…