Jobs at Pivotal Health

Lead and build a standalone State Arbitration/IDR function: set strategy and priorities across ~20 states, formalize filing workflows, recover misrouted claims, manage and scale the operations team, and partner with Data, Product, and Engineering to deliver automation and tooling while owning remittance advice and eligibility judgment logic.

Design, scale, and harden the platform: evolve cloud architecture, build tooling and IaC (Terraform), improve reliability/observability, secure CI/CD and networks, automate developer workflows, and partner with engineering teams to support growth.

Design, evaluate, and productionize decisioning systems that affect pricing, offers, and routing. Run experiments, build models/heuristics and optimization logic under operational constraints, create feedback loops linking model behavior to business outcomes, and partner with engineers to ship improvements. Use AI as an active tool and help the team adopt AI-native workflows.

Design, build, deploy, and maintain production AI systems (LLM-powered and agentic) to automate healthcare reimbursement workflows. Own end-to-end model development, evaluation, monitoring, and continuous improvement; collaborate with product, data, and operations to translate requirements into reliable, scalable systems while ensuring safety, observability, and compliance with healthcare data standards.

Back-end leaning full-stack engineer to build 0-to-1 product experiences: design backend systems, APIs, data flows, and AI-enabled workflows; contribute to React frontends; prototype rapidly and harden production systems while collaborating cross-functionally.

Lead pro forma modeling and deal support for sales and partnerships, own RFP responses, run lifecycle analytics from attribution to retention, improve CRM data hygiene, and automate repetitive revenue processes while partnering cross-functionally.

Lead design and build of greenfield ERP and Salesforce integrations, own money-movement and payment logic, make architectural decisions, write production backend code, document standards, and act as a hands-on technical lead shaping team and systems.

Design, scale, and harden the platform by evolving cloud architecture, building IaC and automation, improving reliability and observability, securing CI/CD and toolchains, and partnering with engineering teams to remove toil and enable scalable, event-driven systems.

Manage federal and state reimbursement dispute cases through IDR and arbitration: evaluate eligibility and documentation, track timelines and correspondence, maintain case records, research state regulations, respond to payor/IDR communications, and contribute to process improvements.

Sell Pivotal Health's reimbursement and IDR platform to hospitals and health systems across the Midwest. Generate pipeline with CFOs and revenue cycle leaders, manage complex multi-stakeholder sales cycles, own account strategy and forecasting, support negotiations and contracting, maintain executive relationships, partner with Customer Success for onboarding and expansion, and improve sales motion and CRM hygiene (Salesforce).

Drive new enterprise sales into hospitals and health systems by building executive relationships, managing complex multi-stakeholder deals from outreach through close, owning account strategy and forecasting in Salesforce, partnering on contracting and customer transition, and identifying expansion opportunities to grow revenue.