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Pivotal Health is a technology platform helping healthcare providers navigate complex reimbursement landscapes and dispute underpaid claims through an AI-driven, full-service solution. The company combines software, data, and service to simplify workflows around Independent Dispute Resolution (IDR) and broader reimbursement operations.
You will join the Case Execution team, which owns critical operational systems including eligibility determination, claim batching, submissions, ops workflows, and claim orchestration. These systems form the operational core of how Pivotal delivers outcomes for providers.
In this role, you will:
- Build and improve core case execution systems, owning backend development across eligibility, batching, submissions, ops workflows, and claim orchestration that determine how cases move through the platform and reach resolution.
- Tackle complex, data-driven backend problems, working through decision logic and data-heavy workflows where eligibility and batching are technically the most demanding areas.
- Contribute to workflow orchestration, building systems that coordinate how cases are staged, routed, and executed end-to-end with a focus on correctness and reliability.
- Collaborate cross-functionally with the Integrations team, Case Strategy team, and other engineering and product partners to ensure systems are well-connected and aligned with the broader platform.
- Contribute to front-end and admin workflows, with the role being primarily backend-focused but requiring contributions to internal-facing UI and ops tooling where needed.
This is a strong fit for an engineer who enjoys solving complex, workflow-driven backend problems and working through data-heavy decision logic. Success means navigating complex eligibility and batching logic, owning workflow-heavy backend systems end-to-end, partnering effectively across teams, and bringing strong judgment to evolving technical problems.
REQUIREMENTS:
- 5+ years of fullstack software engineering experience with a backend focus
- Strong engineering fundamentals with hands-on experience building data-heavy, workflow-oriented systems
- Experience working on complex, data-driven decision logic or orchestration problems; comfort with systems where correctness and sequencing both matter
- Experience contributing to modern React-based applications
- Python experience; able to work effectively in a Python-based backend environment
- Comfortable operating in a collaborative, fast-moving startup environment where ownership and requirements evolve
- Self-directed and proactive; able to identify problems and drive them to resolution without heavy oversight
- Strong communicator who collaborates well across engineering, product, and adjacent teams
EXTRA CREDIT:
- Experience with healthcare-specific data or HealthTech systems
- Exposure to data-heavy architectures or problems adjacent to data engineering
- Familiarity with tools like Snowflake, dbt, or Databricks
