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

We're looking for an Engineering Manager to lead our Infrastructure team as we grow. You'll own the infrastructure, deployment pipelines, and reliability behind Pivotal's platform: infrastructure as code, CI/CD (the automated pipelines that test and ship code), uptime, monitoring, alerting, and observability.

The work runs on two tracks. You'll keep today's systems healthy on GCP with Terraform, GitHub, and serverless Cloud Run, and you'll lead the building of an agentic-first CI/CD workflow, where AI agents carry routine delivery work like speculative deployments and new dev environments. The team's on-call rotation is already in place and mostly runs during working hours.

This is a high-accountability, player-coach role. Our engineers across the company depend on the platform you run, and the problems are often ambiguous. You'll lead an experienced team working closely with engineering partners across Product Engineering, Data Science, and AI Platform, and stay close enough to the technical work to guide architecture and debug production issues alongside the team. The right person will find that combination energizing.

This is a small team with real ownership and no bureaucracy, so decisions reach production quickly. You'll thrive here if you use AI every day, debug production issues to root cause, and explain your reasoning clearly.

What You'll Do

Lead the team

Lead an experienced engineering team: Set clear priorities, coach engineers, create accountability, and make sound decisions while preserving the rigorous technical debate that makes the team stronger.

Grow and structure the team: Hire additional engineers and establish the roles, ownership boundaries, and operating practices the team needs as its scope expands.

Drive predictable delivery: Turn ambiguous infrastructure and platform problems into clear plans, sequence the work, manage dependencies, and make sure the team ships meaningful improvements consistently.

Balance building and maintaining: Keep the systems we run today stable while the team builds what comes next, and make the tradeoffs between the two explicit.

Own the platform

Own infrastructure as code: Ensure Pivotal's Terraform on GCP keeps every environment reproducible, reviewed, and version controlled.

Own CI/CD: Run the pipelines that take code from GitHub to production on Cloud Run, and keep them fast, reliable, and easy for engineers to use.

Build the agentic-first CI/CD workflow: Lead the design of delivery workflows where AI agents handle routine work, including speculative deployments and spinning up new dev environments.

Drive uptime and reliability: Keep production healthy, drive production issues to root cause, and make sure the underlying cause is fixed so the same problem does not return.

Define monitoring, alerting, and observability: Build the signals that tell us something is wrong before our customers do, and tune alerts so they are worth waking up for.

Run a healthy on-call rotation: Support the team's on-call rotation, participate as needed, and improve it as you learn where it hurts.