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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'll join the AI-focused Case Strategy team as a back-end leaning full-stack Staff Software Engineer, building new products from the ground up. This is a high-ambiguity, high-velocity role where you'll own product behavior end-to-end, with particular strength in APIs, backend systems, data flows, and the logic that powers great products. You won't maintain a mature product in a narrow lane; instead, you'll help shape what gets built, how it's built, and how quickly ideas become valuable experiences.
The role emphasizes being AI-first: you should be personally fluent with AI tools, able to use them to move faster and think better, and help the company improve its overall AI adoption. Problems here are real and messy, rooted in actual customer and business pain—not speculative projects. You'll sit at the intersection of AI, product, data, and operations, creating unusual leverage for a strong engineer with genuine room to shape direction.
Key responsibilities include building new product experiences from 0 to 1 across backend services, APIs, integrations, and React-based frontends; designing and implementing backend systems for product logic, orchestration, data access, and AI workflows; contributing to frontend development where product quality depends on tight frontend-backend iteration; working closely with product, design, operations, and AI/ML partners to ship ideas; prototyping quickly then hardening into maintainable systems; building internal and customer-facing workflows using AI, structured data, and automation; defining product requirements through technical judgment; improving quality through instrumentation, testing, and strong engineering hygiene; and actively using AI in your own workflow for coding, debugging, and product exploration.
You're a strong product-minded engineer who likes building things users feel directly. Your center of gravity is backend systems and product logic, though you're comfortable full-stack. You move quickly in ambiguous environments, make good decisions without perfect clarity, and have high ownership—driving work from rough idea to production. You care about product quality, not just technical elegance, and are an AI power user with strong judgment about accelerating engineering and product development. You communicate clearly, work well cross-functionally, and are motivated by environments where great engineers have outsized impact quickly.
Desirable experience includes strong backend work in Python, FastAPI, or similar service-oriented systems; building product backends, APIs, integrations, and data-heavy application logic; meaningful contributions to modern React frontends with TypeScript and modern frameworks; PostgreSQL, SQLAlchemy, or relational data systems; GCP or similar cloud environments; building AI-powered products, internal tools, or operational software; fast-moving startup environments where engineers help define product; and experience in healthcare, fintech, logistics, or other operationally complex domains.
