Full Stack Product Engineer

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 Staff Software Engineer to help build new products at Pivotal from the ground up.

This role sits on the AI/ML Engineering team. You'll work on new product surfaces that combine software, data, workflow design, and AI to solve high-value customer problems. The role is full stack, but intentionally backend-leaning. We're looking for someone who is comfortable owning product behavior end to end while being especially strong in APIs, backend systems, data flows, and the logic that makes great products actually work.

This is a high-ambiguity, high-velocity role. You will not be handed perfectly scoped tickets or asked to maintain a mature product in a narrow lane. You'll help shape what we build, how we build it, and how quickly we can turn ideas into valuable product experiences. The upside is massive impact: the products you work on can materially change how the company operates and how customers experience Pivotal.

We also want someone who is AI-first in how they work. Part of this team's job is building AI-powered products, but part of it is also helping the company get dramatically better at using AI. We want a product engineer who is personally fluent with AI tools and can use them to move faster, think better, and build stronger products.

What You'll Do

• Build new product experiences from 0 to 1 across backend services, APIs, integrations, and frontend workflows.
• Design and implement backend systems that power product logic, orchestration, data access, and AI-enabled workflows.
• Contribute to frontend product development in React-based applications, especially where product quality depends on tight frontend-backend iteration.
• Work closely with product, design, operations, and AI/ML partners to turn ambiguous ideas into shipped product.
• Prototype quickly, then harden what works into maintainable product systems.
• Build internal and customer-facing workflows that use AI, structured data, and software automation to increase leverage.
• Help define product requirements through direct technical judgment, not just implementation after decisions are made.
• Improve product quality through instrumentation, testing, thoughtful system design, and strong engineering hygiene.
• Use AI actively in your own workflow for coding, debugging, investigation, product exploration, and iteration.
• Raise the team's velocity by bringing AI-native working habits, practical engineering judgment, and strong product instincts.

What Success Looks Like

In the first 6 to 12 months, strong outcomes in this role would include:

• shipping meaningful new product capabilities quickly
• taking ownership of backend-heavy product surfaces with minimal oversight
• helping turn vague opportunities into real shipped workflows
• improving product quality and speed through strong engineering execution
• contributing to a team culture that is highly effective at using AI to build and learn faster
• becoming a trusted technical partner to product, design, and operations in a fast-moving environment

Who You Are

• You are a strong product-minded software engineer who likes building things that users feel directly.
• You are full stack, but your center of gravity is backend systems and product logic.
• You are comfortable moving quickly in ambiguous environments and can make good decisions without waiting for perfect clarity.
• You have a high ownership mindset and like driving work from rough idea to production.
• You care about product quality, not just technical elegance.
• You are an AI power user yourself. You actively use AI in your day-to-day work and have strong judgment about how it can accelerate engineering and product development.
• You communicate clearly and work well with cross-functional partners.
• You want to be in an environment where a great engineer can have outsized impact very quickly.

We'd Be Especially Excited If You Have

• strong backend experience in Python, FastAPI, or similar service-oriented systems
• experience building product backends, APIs, integrations, and data-heavy application logic
• experience contributing meaningfully to modern React-based frontend applications
• experience with TypeScript, React Router or Remix-style frameworks, and product UI development
• experience with PostgreSQL, SQLAlchemy, or other relational data systems
• experience with GCP or similar cloud environments
• experience building AI-powered products, internal tools, workflow software, or operational software
• experience in fast-moving startup environments where engineers help define the product, not just implement it
• experience in healthcare, fintech, logistics, or other operationally complex domains

Why This Role Is Interesting

• You'll work on new products, not just incremental maintenance.
• The problems are meaningful, messy, and important. They sit close to real customer and business pain.
• You'll have real room to shape direction. This is a role for someone who wants to help create, not just execute.
• The team sits at the intersection of AI, product, data, and operations, which creates unusual leverage for strong engineers.
• The pace is fast, the ambiguity is real, and the impact can be massive.
• You'll be able to use both sides of your skill set: deep backend engineering and pragmatic full stack product development.

Example Technical Environment

Our current environment includes technologies like:

• Python and FastAPI on the backend
• PostgreSQL and relational data models
• React-based web applications with modern routing and TypeScript
• GCP-hosted services and internal APIs
• AI and workflow systems that combine application logic, structured data, and model-backed experiences

You do not need to match this stack perfectly, but you should be comfortable learning quickly and shipping in this kind of environment.

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, national origin, age, disability, veteran status, or any other legally protected status.

Reasonable Accommodations

Pivotal Health provides reasonable accommodations for qualified individuals with disabilities in accordance with applicable laws. If you need assistance during the application or interview process, please let us know.

Background Checks

Employment is contingent upon successful completion of applicable background checks, where permitted by law.

At-Will Employment

Employment with Pivotal Health is at-will and may be terminated by either party at any time, with or without cause or notice, in accordance with applicable law.