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 Software Engineer to join Pivotal's Integrations team. You'll build and own the backend systems that connect Pivotal's platform to the external data sources, healthcare platforms, billing tools, and partner APIs that our clients and providers depend on. This is a full-ownership role on a small, fast-moving team that is still defining itself. You'll work closely with product, contribute to architectural decisions, and take real accountability for what you ship. The work involves messy real-world data, evolving integration requirements, and close collaboration with internal and external stakeholders, the right person is energized by that, not slowed down by it. What You'll Do - Build and own backend integrations: Design, implement, and maintain the services, pipelines, and APIs that connect Pivotal's platform to external healthcare systems, billing tools, and partner data sources. Take end-to-end ownership from design through production. - Work with real-world healthcare data: Build integrations that handle the practical realities of healthcare data like SFTP-based ingestion, evolving file formats, inconsistent schemas, and complex onboarding workflows with pragmatism and care. - Contribute to architectural decisions: Be an active participant in technical planning and design discussions. Bring your implementation perspective and push back when you see a better path. - Operate with autonomy: With a small team and real ownership, there's no room for passengers. You'll identify what needs solving and drive your work forward without heavy oversight. - Partner closely with product and stakeholders: Work directly with product to understand requirements, clarify scope, and translate integration needs into sound technical plans. Be comfortable in conversations that involve customers, partners, or domain complexity. - Write reliable, maintainable code: Hold a high bar for code quality, testing, and system design. Correctness matters here, these integrations affect real clinical and financial data. - Surface problems early: Communicate blockers, risks, and open questions proactively. Keeping the team aligned is part of doing the job well. Who You Are - 5+ years of software engineering experience with a strong backend focus - Solid understanding of backend fundamentals: system design, data modeling, API development, and service reliability - Comfortable working with database-heavy systems and building around messy, real-world data - Experience building or maintaining integrations with third-party APIs, data pipelines, or external enterprise systems - Comfortable in greenfield environments with evolving requirements and ambiguous ownership - Able to collaborate closely with product, customers, and partners, not just engineering teammates - Self-directed and proactive: you identify problems and drive them to resolution - Strong communicator who surfaces ambiguity early and works well across functions - Experience in early-stage or startup environments where engineers own outcomes, not just tasks Extra Credit If You Have - Experience with healthcare integrations: EDI workflows (835/837), HL7/FHIR, ICD-10/CPT codes, or platforms like Epic or Cerner - Experience with SFTP-based ingestion, data sharing pipelines, or clinical data access workflows - Familiarity with Python in production backend environments - Background in integration-heavy or forward-deployed engineering roles - Background in FinTech, HealthTech, or other regulated industries handling sensitive data - 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 future employer sponsorship. Equal Employment Opportunity Pivotal Health is an Equal Opportunity Employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. We do not discriminate on the basis of race, color, religion, sex, gender identity or expression, sexual orientation