Staff Software Engineer - Integrations

Pivotal Health•New York, NY

2d•$210,000 - $240,000•Hybrid

About The Position

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. We're hiring a Staff Software Engineer to join Pivotal's Integrations team, a backend-focused group building the connections between our platform and the external systems that healthcare providers, clients, and partners depend on, including EHR platforms, billing systems, data feeds, and partner APIs. This is a high-ownership, high-autonomy role on a team that is still defining itself. Architecture, ownership boundaries, and integration patterns are all still being worked out, which means the right person can operate without a clear playbook and bring strong technical judgment to ambiguous problems. You'll be a hands-on technical leader and a force multiplier for the engineers around you and you'll have real influence over how this team approaches some of the hardest integration problems in healthcare.

Requirements

8+ years of software engineering experience with a strong backend focus
Deep systems and database instincts: you're comfortable with database-heavy systems, evolving data pipelines, and the practical challenges of moving and transforming real-world data
Track record of owning architectural decisions on complex, production systems
Comfortable operating with high autonomy in ambiguous, greenfield environments where ownership and architecture are still being worked out
Able to engage in customer and problem discovery: you bring curiosity and good questions, not just implementation depth
Strong product instincts: you care about whether a system is actually useful and correct, not just technically elegant
Self-directed and highly communicative: you surface problems early and drive work forward without waiting for direction
Strong collaborator who can lead through influence and execution, not just title

Nice To Haves

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 pipelines, data sharing workflows, or clinical data access systems
Background in integration-heavy or forward-deployed engineering where working with customer data was central
Familiarity with Python in production backend environments
Background in FinTech, HealthTech, or other data-intensive regulated industries
Experience in startup or high-growth environments where engineers help define the product
Familiarity with Python a plus

Responsibilities

Own the technical direction for integration systems: Drive architectural decisions across the integrations this team builds and maintains, including healthcare data pipelines, SFTP-based ingestion workflows, EHR platform connections, and partner APIs. Set standards the rest of the team builds to.
Build and ship production systems: Stay hands-on. Write production code, lead design reviews, and take end-to-end ownership of the systems you drive.
Design practical systems around messy real-world data: Build integrations that are flexible enough to handle the realities of healthcare data (inconsistent formats, evolving schemas, and complex onboarding workflows) while maintaining clear technical boundaries.
Bridge technical implementation and customer discovery: Help the team understand integration requirements deeply by engaging in problem discovery alongside product and, where relevant, customers and partners. Translate what you learn into sound technical plans.
Translate ambiguity into executable plans: Partner with product and engineering leadership to take loosely defined requirements and turn them into clear, well-scoped work with understood tradeoffs.
Raise the engineering bar: Establish patterns and practices through code, reviews, and direct collaboration that improve quality, reliability, and maintainability across the team.
Operate cross-functionally: Work closely with product, data, platform, and DevOps partners to ensure integrations are secure, well-instrumented, and built for the long term.
Mentor and grow engineers: Be a technical resource and thought partner for senior and mid-level engineers on the team.