Summary

Pivotal Health is looking for a Senior Applied AI/ML Engineer to build and improve high-impact AI systems that sit directly in our most important product and operational workflows. Reporting to the Head of AI/ML Engineering, you will be a key driver in how we use generative AI and intelligence to transform healthcare reimbursement, with a heavy, hands-on focus on building state-of-the-art models.

You will operate at the intersection of generative models, software, product workflows, and business outcomes. Your work will span critical areas such as document generation, dynamic offer engines, and next-generation decisioning systems, where your technical contributions will directly impact our most critical business KPIs. This role requires product-oriented applied engineering-the ability to take ambiguous opportunities and turn them into robust, shipped systems that create measurable value.

This is a role for an engineer who wants to build applied systems, not conduct research in isolation. We are looking for someone who is AI-first in their own work, eager to help our team establish a strong, AI-native way of working, and committed to developing the robust evaluation frameworks (evals) necessary to ensure our systems are production-ready. If you thrive on moving from a rough opportunity to concrete execution quickly, you will love working here.

What You'll Do

• Own and improve hands-on applied AI and ML systems that influence our most critical business KPIs and workflows.
• Build and refine production workflows around generative AI models, including decisioning, retrieval, and orchestration.
• Design and run robust evaluation frameworks (evals) and experiments that improve model quality, workflow quality, and business outcomes.
• Partner with product, operations, and engineering teammates to define success metrics and translate messy real-world problems into buildable systems.
• Improve prompt, model, and workflow behavior through tight feedback loops and practical iteration.
• Contribute to the engineering quality of these systems, including instrumentation, testing, rollout safety, and operational visibility.
• Utilize AI as a force multiplier in your own work and help the team move faster by bringing strong AI-native habits.

Who You Are

• Experience with applied ML, LLM systems, agent workflows, or decisioning systems in production.
• Experience designing and interpreting experiments, evals, or optimization loops.
• Experience with Python and backend systems that support production AI workflows.
• Experience turning messy operational data and product requirements into shipped systems.
• Experience with healthcare or other operationally complex industries.
• A product-oriented mindset with the ability to move from rough opportunity to concrete execution quickly.

Nice To Haves

• Experience in domains like marketplaces, pricing, ad tech, credit decisioning, lending, or revenue optimization.
• Experience with retrieval, prompt engineering, structured generation, model routing, or tool-using agent workflows.

Benefits Include:

• Competitive compensation, including equity
• Full health, dental, and vision coverage
• Retirement savings plan through 401(k)
• Flexible time off
• Opportunities for company-wide connection and events

Ready to Make an Impact?We're building something meaningful; and we want you on the team.

Bring your ideas, curiosity, and drive, and let's transform healthcare reimbursement together.

Employment Information

Work Authorization

Candidates must be authorized to work in the United States without current or future employer sponsorship.