Senior Full-Stack Engineer (Case Strategy)

The role

You will build new product experiences from 0 to 1 across backend services, APIs, integrations, and frontend workflows. This role works on the AI focused Case Strategy team to solve customer problems using software, data, and AI.

What you will do

• Build new product experiences from 0 to 1 across backend services, APIs, integrations, and frontend workflows
• Design and implement backend systems that power product logic, orchestration, data access, and AI-enabled workflows
• Contribute to frontend product development in React-based applications
• Work closely with product, design, operations, and AI/ML partners
• Prototype quickly, then harden what works into maintainable product systems
• Build internal and customer-facing workflows that use AI, structured data, and software automation
• Help define product requirements through direct technical judgment
• Improve product quality through instrumentation, testing, thoughtful system design, and strong engineering hygiene
• Use AI actively in your own workflow for coding, debugging, investigation, product exploration, and iteration
• Raise the team's velocity by bringing AI-native working habits, practical engineering judgment, and strong product instincts

Required qualifications

• Fullstack, but your center of gravity is backend systems and product logic
• Comfortable moving quickly in ambiguous environments
• High ownership mindset
• An AI power user

Nice to have

• Strong backend experience in Python, FastAPI, or similar service-oriented systems
• Experience building product backends, APIs, integrations, and data-heavy application logic
• Experience contributing meaningfully to modern React-based frontend applications, including TypeScript and React Router/Remix-style frameworks
• Experience with PostgreSQL, SQLAlchemy, or other relational data systems
• Experience with GCP or similar cloud environments
• Experience building AI-powered products, internal tools, workflow software, or operational software
• Experience in fast-moving startup environments where engineers help define the product, not just implement it
• Experience in healthcare, fintech, logistics, or other operationally complex domains

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

Before you apply

• Candidates must be authorized to work in the United States without current or future employer sponsorship
• Employment is contingent upon successful completion of applicable background checks, where permitted by law

About the company

Pivotal Health is the leading technology platform that helps healthcare providers get paid fairly in an increasingly complex reimbursement landscape. The company combines software, data, and service into an AI-driven platform to simplify reimbursement workflows.