Senior Fullstack Engineer - Product Platform Engineering

About Pivotal Health 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. About the Role The product platform is the layer other product teams build on. Today that means identity and access, including customer SSO, invitations, and sessions; the organization and tenancy model; the shared services, APIs, and schemas that carry customer data between products; and the developer experience, including the tooling and agent workflows engineers use to ship.

The scope grows whenever product teams need a capability that should be built once. Role-based access control, email infrastructure, the production path for the models our products depend on, and likely data ingress are next in line. When this layer is right, product teams move faster and customers have a better experience. This role is for engineers who think deeply about systems and can explain why a solution works as well as how to build it.

You'll own components and services within the platform end to end, partner closely with product engineering, data, and infrastructure teams, and make the architectural decisions that keep the platform reliable and extensible as the business takes on more customers and more complexity. Expect us to ask about a system you built: who used it, why they cared, and what you would have built differently had you understood that sooner.

What You'll Do Own platform components end to end: Design, build, and operate services, libraries, and schemas within the platform, from design through production, with clear ownership of their reliability and evolution. Design for extension and reuse: Build composable abstractions and well-defined interfaces so product teams can extend the platform without forking it or waiting on you. Design scalable, reliable system interactions: Contribute to the design of system interactions and data flows, making architectural decisions that balance scalability, reliability, security, and performance as the platform evolves.

Improve reliability and operational signal: Build and evolve monitoring, alerting, dashboards, and testing pipelines that surface meaningful signal rather than noise. Reduce toil: Identify repeating patterns across teams and make them composable through better abstractions or new tooling, including AI-assisted tooling where it helps. Partner with product teams: Work as an embedded partner to feature teams, unblock delivery, and make sure platform decisions reflect what those teams actually need.

Who You Are 5+ years of experience in fullstack, backend or platform software engineering Strong software engineering foundation with solid coding skills; Python preferred Hands-on experience designing and operating cloud-native systems; GCP preferred Experience with relational databases and data modeling, including schema evolution in production Familiarity with event-driven architectures (Kafka, Pub/Sub, Kinesis, or similar) Range to move between domains such as authorization, messaging infrastructure, and data pipelines without needing each to be familiar first Strong product insti