--- title: 'Staff Site Reliability Engineer at Pivotal Health' canonical: 'https://feeny.ai/job/staff-site-reliability-engineer-pivotal-health-williamsburg-6qptrrnxk17d' type: 'job' last_seen: '2026-09-06' --- # Staff Site Reliability Engineer at Pivotal Health - **Company:** Pivotal Health - **Location:** Williamsburg, NY - **Compensation:** $230k–$250k - **Employment:** full-time - **Work type:** hybrid - **Posted:** 2026-08-20 - **Last confirmed live:** 2026-09-06 - **Apply:** https://jobs.ashbyhq.com/pivotal-health/7823d32f-8102-433f-bbeb-03fdaa7b3d61 ## Job description ## 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 hiring a Staff Site Reliability Engineer to define and strengthen how reliability, scalability, and operational excellence are built into Pivotal’s platform. This is a senior individual contributor role with broad influence across engineering. You’ll work hands-on with our infrastructure and production systems while setting the technical direction for reliability across the company. You’ll help us evolve from a rapidly growing platform into one that can scale predictably, recover gracefully, and meet the high standards of availability, security, and auditability required in healthcare. You’ll partner closely with software, data, AI, security, and product teams to design resilient systems, improve observability, reduce operational risk, and make reliability a shared engineering responsibility. You’ll bring the technical depth to solve our most difficult infrastructure challenges and the leadership to establish practices that raise the bar for the entire organization. If you’re energized by complex distributed systems, greenfield infrastructure work, and the opportunity to shape reliability at a pivotal stage of company growth, this is the role for you. ## WHAT YOU'LL DO - Set Pivotal’s reliability strategy: Define the technical vision and roadmap for reliability, availability, scalability, and operational readiness. Establish clear service-level objectives and help teams make informed tradeoffs between reliability, velocity, and cost. - Design resilient, scalable infrastructure: Guide and implement improvements to our cloud architecture, deployment systems, networking, compute, storage, and other shared infrastructure. Ensure our systems can scale with increasing product usage, data volume, and workflow complexity. - Build world-class observability: Develop a cohesive approach to metrics, logs, traces, dashboards, and alerting. Give engineers the visibility they need to understand system behavior, identify emerging issues, and resolve production incidents quickly. - Improve incident response and resilience: Establish effective incident management, on-call, postmortem, and disaster recovery practices. Lead the response to complex incidents and ensure lessons result in durable improvements to our systems and processes. - Reduce operational toil through automation: Identify recurring manual work and build systems, tooling, and automation that make operating Pivotal’s platform safer and more efficient. Improve deployment workflows, capacity management, infrastructure provisioning, and production diagnostics. - Embed reliability across engineering: Partner with software, data, and AI engineers to improve system design, production readiness, and failure handling. Create reusable patterns, tooling, and standards that allow teams to build reliable services without becoming dependent on a centralized operations function. - Strengthen security and compliance: Work closely with security and compliance stakeholders to protect sensitive healthcare and financial data. Help ensure our infrastructure, access controls, audit trails, and operational practices meet applicable regulatory and customer requirements. - Provide technical leadership: Serve as a trusted technical partner to senior engineers and engineering leaders. Lead architecture reviews, mentor engineers, clarify complex tradeoffs, and raise the standard for infrastructure and operational engineering across the organization. ## WHO YOU ARE - 8+ years of experience in site reliability engineering, infrastructure engineering, platform engineering, or operating large-scale production systems - Deep knowledge of cloud infrastructure, distributed systems, networking, containers, orchestration, infrastructure as code, and modern deployment practices - Experience designing, building, and operating highly available systems in a fast-growing production environment - Strong understanding of observability, service-level objectives, capacity planning, incident management, disaster recovery, and performance engineering; Hands-on and technically credible, with the ability to debug complex issues across application, infrastructure, network, and data layers - Experienced in creating automation and internal tooling that reduces operational toil and improves developer productivity - Comfortable influencing architecture and engineering practices across teams without relying on formal authority - A thoughtful communicator who can translate operational risk and technical tradeoffs for engineering, product, security, and business stakeholders; Pragmatic about balancing reliability, delivery speed, complexity, and cost - Comfortable operating in ambiguity and building from scratch—you’re energized by greenfield work, not slowed down by it ## EXTRA CREDIT IF YOU HAVE - Experience operating infrastructure that handles healthcare, financial, or other sensitive and regulated data - Familiarity with HIPAA, PHI, SOC 2, data privacy, auditability, and security controls - Experience supporting data-intensive, AI, or machine learning systems in production - Experience with multi-region architecture, high-volume asynchronous workflows, or complex distributed processing systems - A track record of introducing SRE practices at an early-stage or high-growth company ## WHY YOU’LL LOVE WORKING HERE We’re a collaborative, low-ego team on a mission to make healthcare reimbursement fairer for providers. While we primarily hire around our core hubs–Los Angeles and New York–we remain open to exceptional talent outside those regions. Remote and hybrid flexibility varies by role and team, and is outlined in each job description. If you’re excited by solving complex problems and making a real-world impact, we’d love to hear from you. 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. ## Equal Employment Opportunity Pivotal Health is an Equal Opportunity Employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. We do not discriminate on the basis of race, color, religion, sex, gender identity or expression, sexual orientation, national origin, age, disability, veteran status, or any other legally protected status. Reasonable Accommodations Pivotal Health provides reasonable accommodations for qualified individuals with disabilities in accordance with applicable laws. If you need assistance during the application or interview process, please let us know. Background Checks Employment is contingent upon successful completion of applicable background checks, where permitted by law. At-Will Employment Employment with Pivotal Health is at-will and may be terminated by either party at any time, with or without cause or notice, in accordance with applicable law. ## About Pivotal Health ## Company Overview - **One-liner**: Pivotal Health provides a full-service Independent Dispute Resolution (IDR) platform that combines software, data, and AI to help healthcare providers secure fair reimbursement from payers. - **Entity Type**: Private (Startup) - **Headquarters**: Morrison, Colorado, United States - **Founded**: 2022 - **Founders**: Max Mangum and Josh Folds ## Core Business - **Primary industry**: Healthcare Technology / Revenue Cycle Management (RCM) / Independent Dispute Resolution (IDR) - **Target customers**: B2B — healthcare providers, including independent physician groups, hospital systems, and RCM teams - **Mission**: Create technology that helps providers achieve fair reimbursement. - **Vision**: Restore the balance between providers and payers. ## Products & Services - **Pivotal Health IDR Platform**: A full-service, technology-driven Independent Dispute Resolution platform. It combines software, proprietary data, and AI to automate and manage the entire IDR workflow under the No Surprises Act. The platform integrates with all major hospital-based RCM systems and handles eligibility, dispute filing, and reimbursement tracking. - **White-Glove Service**: A high-touch, outcomes-aligned service model where Pivotal Health only gets paid after the client gets paid. No hidden fees, no lock-in contracts. ## Market Standing - **Valuation/Market Cap**: Not publicly available (private company) - **Key Metric**: Total Funding — Not publicly disclosed; company is privately held and appears to be growth-stage (41 employees, rapid hiring). - **Notable Investors/Partners**: Not publicly disclosed. The company was founded by Max Mangum and Josh Folds, who previously built Radix Health (the company's former name). - **Growth Signals**: Headcount grew **414.3% year-over-year** to 41 employees. The company rebranded from Radix Health to Pivotal Health in 2025. It is actively hiring across engineering, sales, and operations roles (41 open positions as of mid-2025). Monthly headcount growth is +26.3%. ## Competitive Advantages - **Outcomes-Aligned Pricing**: Pivotal Health is the only IDR partner that gets paid *after* the client gets paid, creating a strong alignment of incentives and reducing financial risk for providers. - **Full-Service Platform**: Combines proprietary software, data intelligence, and AI with a white-glove service team, offering a complete solution rather than just a point tool. - **Deep Integration**: Integrates with all major hospital-based RCM platforms, making setup seamless and reducing friction for provider clients. - **Founding Team Insight**: Founded by Max Mangum and Josh Folds, who have deep domain expertise in healthcare reimbursement and built the company from a personal mission to fix a broken system. ## Strategic Focus - **Product & AI Development**: Heavy investment in AI/ML engineering (hiring Senior Applied AI/ML Engineers and a Senior Applied Scientist for Decisioning) to further automate and optimize the IDR workflow. - **Platform Integration**: Building out systems integration capabilities (hiring Staff and Senior Software Engineers for Systems Integration) to connect seamlessly with more RCM platforms. - **Scaling the Team**: Rapidly growing headcount (414% YoY) across all departments, with a focus on engineering, sales, and client success to support expanding provider partnerships. - **Rebranding & Market Positioning**: The recent rebrand from Radix Health to Pivotal Health signals a strategic push to own the "fair reimbursement" narrative and expand beyond the initial IDR use case. ## Why Work Here - **Mission-Driven Work**: Employees directly contribute to restoring fairness in the healthcare reimbursement system, helping providers get paid fairly for the care they deliver. - **High Growth Environment**: The company is scaling extremely fast (414% headcount growth YoY), offering significant career growth opportunities and the chance to shape processes and culture. - **Hybrid Work Model**: Pivotal Health operates with a hybrid workspace, with offices in Morrison, Colorado, and New York, NY. Employees engage in a combination of remote and on-site work. - **Strong Engineering Culture**: The company is investing heavily in AI/ML and platform engineering, with open roles for Staff Security Engineers, Senior Applied AI/ML Engineers, and Senior Platform Engineers. - **Outcomes-Aligned Philosophy**: The company's "get paid when you get paid" model extends to its culture, emphasizing transparency, fairness, and partnership. ## Sources 1. [pivotalhealth.ai](https://pivotalhealth.ai/) 2. [pivotalhealth.ai/about-us](https://pivotalhealth.ai/about-us) 3. [pivotalhealth.ai/careers](https://pivotalhealth.ai/careers) 4. [LinkedIn](https://www.linkedin.com/company/pivotal-health-ai) 5. 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