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 Senior Full Stack Engineer to join Pivotal's Growth & Onboarding team. You'll build the customer-facing product surfaces and backend systems that bring new providers onto the platform and help them realize value quickly, spanning onboarding flows, customization workflows, benchmarking tools, and the surfaces that support sales and marketing in growing Pivotal's provider base. This team sits at the earliest and most visible part of the customer lifecycle, and the right person cares deeply about that. You'll work cross-functionally with product, sales, and marketing alongside engineering, and you'll own features end to end across a Python-oriented backend and React-based frontend. The role is frontend-leaning but genuinely full stack, you should be comfortable and capable across both. What You'll Do - Build and own fullstack features across growth surfaces: Design, implement, and maintain both the backend services and frontend workflows that power provider onboarding, customization, benchmarking, and sales and marketing support tooling. Own features end to end. - Build customer-facing product UI: Develop clean, functional React-based interfaces that guide providers through onboarding flows, expose customization options, and surface the information they need to get value from the platform quickly. - Contribute to backend systems: Work on the APIs, data models, and service logic that underpin onboarding and growth workflows. Bring backend depth alongside your frontend skills. - Work cross-functionally with sales, marketing, product, and design: This team is a key customer touchpoint. You'll collaborate with go-to-market stakeholders as much as engineering ones, and you'll need to translate their needs into well-scoped technical solutions. - Contribute to architectural decisions: Participate actively in technical planning and design discussions. Bring your full-stack perspective and push back when you see a better path. - Write reliable, maintainable code across the stack: Hold a high bar on both sides, well-structured APIs and data models on the backend, clean and performant component-level code on the frontend. - Surface problems early: Communicate blockers, risks, and open questions proactively. On a small team, keeping everyone aligned is part of doing the job well. Who You Are - 5+ years of software engineering experience, genuinely comfortable across backend and frontend - Strong backend fundamentals: system design, data modeling, API development, and service reliability - Solid frontend experience in React-based applications, including TypeScript, modern routing, and component-level product development - Strong product orientation with a genuine interest in customer experience, especially at the earliest stages of the customer lifecycle - Comfortable working cross-functionally with sales, marketing, product, and design stakeholders - Python experience preferred on the backend; candidates from other backend languages are welcome if they're prepared to interview in Python and ramp quickly - Able to complete a React-based full-stack technical interview and meet backend Python expectations in the broader process - Comfortable in greenfield environments with evolving requirements - Self-directed and proactive: you identify problems and drive them to resolution - Experience in early-stage or startup environments where engineers own outcomes, not just tasks Extra Credit If You Have - Experience building onboarding flows, customization tooling, benchmarking tools, or sales and marketing support surfaces - Familiarity with experimentation, feature flagging, or A/B testing - Background in FinTech, HealthTech, or other regulated industries - Familiarity with FastAPI or similar Python backend frameworks - Familiarity with TypeScript, React Router, or Remix-style frameworks - Familiarity with Python a plus 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 fu