Senior IT Systems Engineer

Garner Health•New York, NY

5h•Hybrid

About The Position

Garner's mission is to transform the healthcare economy, delivering high-quality and affordable care for all. We are fundamentally reimagining how healthcare works in the U.S. by partnering with employers to redesign healthcare benefits using clear incentives and powerful, data-driven insights. Our approach guides employees to higher-quality, lower-cost care, creating a system that works better for everyone. Patients achieve better health outcomes, employers spend healthcare dollars more effectively, and physicians are rewarded for delivering exceptional care rather than performing more procedures. Garner is one of the fastest-growing healthcare technology companies in the country. Our products are trusted by the most sophisticated employers and providers in the industry, and we are building a team of talented, mission-driven individuals who are motivated to make a meaningful impact on healthcare at scale. About the role: We are looking for an engineer who can walk into messy, cross-functional workflows and turn them into clean, automated systems that scale. This role focuses on identifying high-friction operational processes across the company and replacing them with durable, API-driven automation. You will work across IT, Security, Engineering, and Business teams to reduce manual work, improve reliability, and build systems that scale with the company. This is not a ticket-driven IT role. You will operate with a high degree of ownership, driving initiatives end-to-end from problem discovery through implementation and rollout. You will be part of the Business Technology - Corporate Engineering team and report to the Director of Business Technology.

Requirements

4–7+ years of experience in IT, platform engineering, automation, or similar roles
Strong scripting or programming ability in Python, Go, Node.js, PowerShell, or similar
Experience building API-driven automation across multiple systems
Ability to design and implement workflows that span multiple tools and teams
Experience with infrastructure-as-code such as Terraform or similar
A desire to be part of a high-performing, mission-driven team that operates with intense urgency, a strong sense of individual accountability, and a commitment to authentic feedback

Nice To Haves

Hands-on experience with identity and access systems (Okta, SSO, SCIM, RBAC), including implementation and ongoing management
Proven ability to build and scale internal tools using platforms like Retool or other low-/no-code solutions
Familiarity with security automation and orchestration (e.g., Tines), with an eye toward reducing manual effort and risk
Practical experience leveraging AI/LLMs to streamline and enhance operational workflows
Strong understanding of compliance and security standards (HIPAA, SOC 2, HITRUST) and how they shape systems and processes
Focused on driving meaningful outcomes
Able to identify root-cause, system-level issues and design durable solutions rather than quick fixes
Comfortable navigating cross-functional environments with competing priorities and constraints
Operates with urgency while building scalable, maintainable solutions
Defaults to automation and efficiency wherever possible

Responsibilities

Identify and automate high-impact operational workflows across onboarding, offboarding, access management, and service delivery
Replace manual, fragmented processes with scalable, API-driven systems
Build and maintain integrations across HRIS, identity providers, SaaS platforms, and cloud environments
Develop internal tools and automation using platforms like Retool, Okta Workflows, and custom scripts or services
Apply infrastructure-as-code to manage and version system configurations
Incorporate AI into workflows to improve efficiency in areas like ticket routing, knowledge retrieval, and decision support
Design and automate access and security workflows that enforce least-privilege and auditability
Own and drive cross-functional initiatives end-to-end, from problem definition through implementation and rollout