Pivotal Health

Analyst

• Evaluate dispute eligibility and documentation: Analyze claim information to ensure cases meet federal IDR or state-specific dispute requirements before submission.
• Research and interpret state regulatory requirements: For state-specific work, independently research state laws, regulations, agency guidance, payer requirements, and arbitration procedures; interpret how they apply operationally; and translate that research into clear, reliable instructions and workflows for the rest of the team.
• Own inbox and correspondence review: Monitor shared inboxes and respond to incoming emails from payors and IDR entities, tracking follow-ups and next steps for each case.
• Ensure accurate case closures: Confirm disputes are closed only when truly resolved, catching premature or missed closures before they affect reimbursement.
• Monitor arbitration timelines and correspondence: Track deadlines and review communications from health plans, arbitration entities, and internal teams to ensure cases progress appropriately.
• Maintain operational tracking and documentation: Update internal systems and spreadsheets to maintain accurate case records, dispute statuses, and operational metrics.
• Support operational improvements: Contribute to refining workflows and documentation as the team builds more scalable dispute management processes, and flag documentation or system issues to our analytics and product teams when case files are incomplete or inaccurate.

IDR Analyst – Federal and State

Manager

• Own state arbitration strategy end to end. Decide which states we pursue, in what order, and why. Turn a function that's been informal and reactive into a deliberate, prioritized roadmap.
• Build the state filing process from the ground up. Formalize how, when, and where we file across the ~20 states with real volume, replacing ad hoc handling with a repeatable operating model.
• Lead and grow the State Arbitration team. Take over management of the existing team, including direct oversight of state arbitration staff, and hire quickly to scale the function as it formalizes.
• Recover misrouted claims. Identify volume currently flowing into the federal IDR process that should be filed at the state level, and build the workflows to catch and correctly route it going forward.
• Partner with Data & Analytics. Work closely with the analytics team to surface trends in claims and outcomes, and use that data to sharpen which states and strategies we invest in.
• Drive the product roadmap for state arbitration. Partner with Product and Engineering to translate operational reality (eligibility rules, filing requirements, remittance advice complexity) into the tools and automation the team needs.
• Own remittance advice and eligibility determination. Bring clarity to where claims sit between federal and state processes, and build the judgment calls into scalable, documented logic rather than one-off decisions.
• Take on broader department management. Assume ownership of responsibilities currently held by Operations leadership, running state arbitration as its own accountable department rather than a shared responsibility.

Senior Manager, State IDR

• Act as go-to for Client Success on payor compliance questions
• Lead deep-dive payor reviews to identify payment blockages
• Serve as first point of contact for outreach campaigns
• Build CS-facing materials and sharpen SOPs as workflows evolve

Optimization Analyst

• Own end-to-end client operations for a portfolio of clients- proactively monitoring data, surfacing trends, and resolving issues (file delivery issues, ineligibility spikes, payment anomalies, data quality gaps) before they become client-raised escalations.
• Work closely with implementations teams to understand the nuances and complexity of each clients setup and be the point person after go live for ensuring continued implementation quality
• Use Metabase, BigQuery, and our internal reporting tools to turn operational signal into client-facing strategy: AR aging deep-dives, ineligibility analyses, and process recommendations. Build dashboards to surface important information in a timely manner, and then act on it.
• Serve as a credible strategic counterpart to our Client Success team partners and our clients- walking into every conversation with a recommendation, not just data. You are not just fixing things that break, you are a thoughtful partner with ideas on how we can move the lever for our clients
• Partner cross-functionally on IDR strategy and payer compliance work, leading special projects across the company and org that push our IDR model forward.
• Help scale and our build our team out as we rapidly grow- collaborate on internal playbooks and onboarding documentation, and consistently work to improve our internal processes, use AI to help automate manual tasks on the team; always focused on building an operating system that helps us scale.

Senior Analyst

Engineering Manager

• Stand up and shape a new team: Help define how the Integrations function operates (hiring, scope, rituals, and engineering culture) while the team is still being built and ownership boundaries are still being established.
• Lead as a player-coach: Contribute code, perform design reviews and PRs, and guide technical strategy while supporting the growth and effectiveness of the team.
• Own the Integrations surface: Take end-to-end engineering ownership of the systems that connect Pivotal's platform to customers, external data sources, healthcare platforms,, and any partner APIs. Ensure integrations are reliable, scalable, and maintainable as the catalog grows.
• Join customer and partner conversations: Be the technical voice in discovery and scoping conversations with customers and external partners. Ask the right questions, understand integration requirements deeply, and bring that context back into engineering execution.
• Partner deeply with product: Collaborate closely with product to gather requirements, clarify scope, and translate integration needs into executable technical plans. Help shape solutions early rather than reacting late.
• Drive execution and delivery: Own the engineering side of delivery (sprint planning, standups, retros, prioritization) ensuring the team ships consistently and learns from each cycle.
• Translate ambiguity into clarity: Take loosely defined problems and help the team break them down into clear, achievable work with well-understood tradeoffs and success criteria.
• Build lightweight process and rituals: Establish and evolve team workflows that improve focus and predictability without unnecessary ceremony.
• Support and grow engineers: Coach engineers on execution, communication, and ownership across both IC and managerial tracks.

Engineering Manager – Integrations

• Stand up and shape a new team
• Lead as a player–coach
• Own the Growth & Onboarding surface
• Partner cross-functionally with product, sales, and marketing
• Guide customer-facing engineering
• Drive execution and delivery
• Translate ambiguity into clarity
• Build lightweight process and rituals
• Support and grow engineers

Engineering Manager – Growth, Onboarding

Full-stack Engineer

• 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.

Staff Software Engineer – Integrations

Staff Software Engineer – Growth, Onboarding

• Build and own backend integrations: Design, implement, and maintain the services, pipelines, and APIs that connect Pivotal's platform to external healthcare systems, billing tools, and partner data sources. Take end-to-end ownership from design through production.
• Work with real-world healthcare data: Build integrations that handle the practical realities of healthcare data like SFTP-based ingestion, evolving file formats, inconsistent schemas, and complex onboarding workflows with pragmatism and care.
• Contribute to architectural decisions: Be an active participant in technical planning and design discussions. Bring your implementation perspective and push back when you see a better path.
• Operate with autonomy: With a small team and real ownership, there's no room for passengers. You'll identify what needs solving and drive your work forward without heavy oversight.
• Partner closely with product and stakeholders: Work directly with product to understand requirements, clarify scope, and translate integration needs into sound technical plans. Be comfortable in conversations that involve customers, partners, or domain complexity.
• Write reliable, maintainable code: Hold a high bar for code quality, testing, and system design. Correctness matters here; these integrations affect real clinical and financial data.
• Surface problems early: Communicate blockers, risks, and open questions proactively. Keeping the team aligned is part of doing the job well.

Senior Software Engineer – Integrations

• Build and own backend systems: Design, implement, and maintain the services and APIs that power provider onboarding, activation, customization workflows, and growth-oriented tooling. Take end-to-end ownership from design through production.
• Build practical customer-facing tools: Translate what providers, sales, and marketing need at the earliest stages of the customer lifecycle into reliable, well-designed backend systems and workflows.
• Contribute to architectural decisions: Be an active participant in technical planning and design discussions. Bring your implementation perspective and push back when you see a better path.
• Partner cross-functionally: Work closely with product, sales, and marketing stakeholders, not just engineering. This team is a key customer touchpoint and the right person is comfortable in that cross-functional environment.
• Operate with autonomy: With a small team and real ownership, there's no room for passengers. You'll identify what needs solving and drive your work forward without heavy oversight.
• Write reliable, maintainable code: Hold a high bar for code quality, testing, and system design. Build things that hold up as the platform and team scale.
• Surface problems early: Communicate blockers, risks, and open questions proactively. Keeping the team aligned is part of doing the job well.

Senior Software Engineer – Growth, Onboarding

• Stand up and shape a new team: Help define how the Integrations function operates (hiring, scope, rituals, and engineering culture) while the team is still being built and ownership boundaries are still being established.
• Lead as a player-coach: Contribute code, perform design reviews and PRs, and guide technical strategy while supporting the growth and effectiveness of the team.
• Own the Integrations surface: Take end-to-end engineering ownership of the systems that connect Pivotal's platform to customers, external data sources, healthcare platforms, and any partner APIs. Ensure integrations are reliable, scalable, and maintainable as the catalog grows.
• Join customer and partner conversations: Be the technical voice in discovery and scoping conversations with customers and external partners. Ask the right questions, understand integration requirements deeply, and bring that context back into engineering execution.
• Partner deeply with product: Collaborate closely with product to gather requirements, clarify scope, and translate integration needs into executable technical plans. Help shape solutions early rather than reacting late.
• Drive execution and delivery: Own the engineering side of delivery (sprint planning, standups, retros, prioritization) ensuring the team ships consistently and learns from each cycle.
• Translate ambiguity into clarity: Take loosely defined problems and help the team break them down into clear, achievable work with well-understood tradeoffs and success criteria.
• Build lightweight process and rituals: Establish and evolve team workflows that improve focus and predictability without unnecessary ceremony.
• Support and grow engineers: Coach engineers on execution, communication, and ownership across both IC and managerial tracks.

Senior Fullstack Engineer – Growth, Onboarding

Accountant

• Own Core Accounting Operations: Take responsibility for weekly customer billing, cash postings, expense report reviews, AP processing, reconciliations, and key components of the monthly close process. Ensure accuracy, timeliness, and consistency across all core workflows.
• Build a Predictable Close Process: Help design and strengthen our month-end and year-end processes so we move from reactive processes to a robust and structured full accounting process. Improve documentation, controls, and accountability so we consistently hit deadlines with confidence.
• Partner Across the Business: Serve as a trusted partner to Operations, Sales, and FP&A on invoicing, commissions, reconciliations, and reporting. Coordinate directly with cross-functional teams to resolve discrepancies and improve clarity.
• Support ERP Implementation and Optimization: Play an active role in implementing and refining our new ERP system. Participate in testing, validation, reporting design, and process improvements to ensure the system supports scale.
• Improve Systems and Reduce Manual Work: Identify inefficiencies and areas of risk in current processes. Recommend and implement improvements that increase accuracy, reduce friction, and prepare us for growth and audit readiness.
• Prepare Us for Audit & Scale: Help ensure our financial records are well-documented and audit-ready as we prepare for our first financial audit and continued growth.

Staff Accountant

Data Engineer

• Own warehouse platform architecture. Design and evolve the systems that support storage, transformation, governance, and access across clinical datasets.
• Build scalable data infrastructure. Develop a secure and compliant warehouse infrastructure.
• Healthcare-specific data modeling: Design and build clinical data models inside a scalable warehouse solution.
• Design warehouse optimization strategies. Create data models and storage approaches that balance performance, scalability, and maintainability.
• Establish data governance frameworks. Implement controls that ensure data quality, consistency, security, and auditability.
• Enable downstream analytics and AI workloads. Build infrastructure that supports reporting, evidence generation, and machine learning applications.
• Lead cross-functional technical initiatives. Partner with engineering, analytics, and product teams to align platform capabilities with business priorities.
• Improve platform observability and reliability. Build monitoring, alerting, and operational tooling that ensures trust in critical data systems.

Staff Software Engineer, Data Warehouse

• Own data pipeline development. Build and maintain reliable pipelines that ingest, transform, and deliver healthcare data across the organization.
• Design warehouse data models. Create scalable schemas and data structures that support analytics, reporting, and evidence generation.
• Lead data transformation strategy. Establish frameworks and standards that improve consistency, maintainability, and performance.
• Ensure data quality and trust. Implement validation, reconciliation, monitoring, and alerting processes across critical datasets.
• Support clinical data integration initiatives. Help incorporate new clinical data sources into the warehouse ecosystem.
• Optimize warehouse performance. Improve query efficiency, storage utilization, and processing costs as data volumes grow.
• Partner with stakeholders on data requirements. Translate business questions into durable data solutions and trusted datasets.
• Improve operational excellence. Develop tooling and processes that increase reliability and reduce manual intervention.
• Mentor data engineers and analysts. Share best practices and elevate technical standards across the data organization.

Staff Data Engineer, Data Warehouse

• Own clinical data extraction architecture. Design and evolve the systems that ingest, process, and normalize structured and unstructured clinical data from multiple healthcare sources.
• Build document intelligence pipelines. Develop services that extract meaningful information from PDFs, scanned records, images, and clinical documentation.
• Lead healthcare data modeling efforts. Create approaches for transforming raw clinical artifacts into structured, queryable datasets.
• Develop scalable ingestion services. Design resilient systems capable of processing large volumes of healthcare records with high reliability and accuracy.
• Build scalable data extraction systems. Leverage the best available technologies and architectural approaches to improve information extraction, classification, and normalization across diverse healthcare data sources.
• Establish data quality standards. Create validation frameworks, monitoring systems, and feedback loops that improve extraction accuracy over time.
• Influence and collaborate across clinical, product, engineering, data, and operational domains: Driving alignment on business objectives and translating them into technical systems that support provider evidence generation.
• Drive technical strategy for unstructured healthcare data. Evaluate technologies, standards, and architectural approaches that accelerate clinical data adoption.
• Mentor engineers across the organization. Raise engineering standards through design reviews, technical leadership, and hands-on collaboration.