Senior Fullstack Engineer - Case Execution

Pivotal Health, Inc.

$130K — $155K *
Healthcare
5 - 7 years of experience
Job Overview by Ladders

Qualifications

  • 5+ years of fullstack software engineering experience with a backend focus
  • Strong fundamentals in building data-heavy, workflow-oriented systems
  • Experience with complex decision logic and orchestration problems
  • Familiarity with modern React-based applications
  • Proficient in Python for backend environments
  • Ability to work in a collaborative, fast-paced startup setting
  • Self-directed problem solver with strong communication skills

Responsibilities

  • Build and enhance core case execution systems involved in eligibility and batching
  • Solve complex data-driven backend challenges in the eligibility and batching areas
  • Contribute to the coordination of case workflows from start to finish
  • Collaborate with cross-functional teams to ensure systems integration
  • Support internal-facing UI and operational tools when necessary

Benefits

  • 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
Full Job Description
About the Role

We're hiring a Senior Fullstack Engineer to join Pivotal's Case Execution team. This team owns critical parts of the case execution workflow, including eligibility, batching, submissions, ops workflows, and claim orchestration. These systems sit at the operational core of how Pivotal delivers outcomes for providers.

This is a strong fit for an engineer who enjoys solving complex, workflow-driven backend problems and working through data-heavy decision logic. The most technically demanding areas for this team are eligibility and batching, and the right person is energized by that kind of work rather than looking to avoid it.

What You'll Do
  • Build and improve core case execution systems: Own backend development across eligibility, batching, submissions, ops workflows, and claim orchestration. These are the systems that determine how cases move through Pivotal's platform and reach resolution.
  • Tackle complex, data-driven backend problems: Work through the decision logic and data-heavy workflows that make eligibility and batching hard, understanding not just how individual systems work, but how they interact across the broader platform.
  • Contribute to workflow orchestration: Build and improve the systems that coordinate how cases are staged, routed, and executed end to end, with a clear eye toward correctness and reliability.
  • Collaborate cross-functionally: Work closely with the Integrations team, Case Strategy team, and other engineering and product partners to ensure systems are well-connected and aligned with how the broader platform operates.
  • Contribute to front-end and admin workflows: The role is primarily backend-focused, but you'll contribute to internal-facing UI and ops tooling where the product requires it.

Who You Are
  • 5+ years of fullstack software engineering experience with a backend focus
  • Strong engineering fundamentals with hands-on experience building data-heavy, workflow-oriented systems
  • Experience working on complex, data-driven decision logic or orchestration problems: you're comfortable with systems where correctness and sequencing both matter
  • Experience contributing to modern React-based applications
  • Comfortable operating in a collaborative, fast-moving startup environment where ownership and requirements evolve
  • Python experience; able to work effectively in a Python-based backend environment
  • Self-directed and proactive: you identify problems and drive them to resolution without heavy oversight
  • Strong communicator who collaborates well across engineering, product, and adjacent teams

Extra Credit If You Have
  • Experience with healthcare-specific data or HealthTech systems
  • Exposure to data-heavy architectures or problems adjacent to data engineering without being a pure data engineer
  • Familiarity with tools like Snowflake, dbt, or Databricks

What Success Looks Like
  • You can navigate complex eligibility and batching logic and make sound decisions in ambiguous technical territory
  • You're comfortable owning workflow-heavy backend systems end to end
  • You partner effectively with engineering, product, and adjacent teams without needing heavy coordination overhead
  • You bring strong judgment to evolving technical problems and help the team move faster as a result


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.

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