Healthcare quality is declining and soaring costs are crushing American families and businesses. At Garner, we’ve developed a revolutionary approach to evaluating doctor performance and a unique incentive model that's reshaping the healthcare economy to ensure everyone can afford high quality care. By providing organizations relief from surging healthcare costs, we've experienced rapid adoption in the market and have more than doubled our revenue annually over the last 5 years, becoming the fastest growing company in our space. To support our continued growth, we're expanding our team by over 50% each year, seeking exceptional talent to shape our unique, award winning culture (for example, USA Today Top Workplaces 2025) designed to cultivate teamwork, trust, autonomy, exceptional results, and individual growth that creates an inflection point in your career.
The Senior IT Systems Engineer (L3) is a foundational and highly technical role responsible for designing, building, and maintaining the internal systems that empower Garner's employees. Your mission is to solidify the operational and security foundations, focusing on abstracting common services (Identity, Configuration, Data Access) to reduce technical debt across the organization. You will leverage low-code platforms (Retool, Okta Workflows) as key development tools for delivering bespoke solutions and driving automation. This role demands an owner-mindset, deep technical competence, and a commitment to designing resilient, secure, and scalable internal systems. You will be part of the Business Technology - Corporate Engineering team and report to the Director of Business Technology.
Where you will work:This role will be based in our New York City office. You must be willing to work in the office 3 days per week on Tuesday, Wednesday and Thursday.
What you will do:- Own the Internal Tooling Platform: Design and build the standards and reusable components for Garner's growing internal tooling platform, primarily using low-code/no-code frameworks (Retool, AppSmith, etc.)
- Develop Automation as a Service: Create and maintain resilient business process automation and integrations that enhance IT Service Delivery, user experience, and compliance
- Architect Core Infrastructure: Serve as the SME for corporate identity (Okta) and modern endpoint configuration management (MDM), ensuring these systems function as the reliable foundation of our services
- Streamline ITSM Workflows: Proactively automate high-impact Service Delivery workflows, including onboarding/offboarding, RBAC enforcement, and SaaS lifecycle management
- Enforce Compliance: Contribute to Garner's security posture by building workflows and controls that support least-privilege access, auditability, and data protection required for high-compliance environments (HIPAA, HITRUST, SOC2)
- Drive Architectural Clarity: Develop process maps (e.g., BPMN) to clarify system flows and align stakeholders around future-state platform designs
- Corporate Engineering Mindset: L3 experience (3-5+ years) in enterprise IT or internal tools engineering, focusing on creating reusable, scalable infrastructure components for internal customers
- Low-Code Mastery: Advanced experience designing and building automations in tools like Retool, Okta Workflows, or similar low-code platforms (N8N, Budibase)
- Systems Architecture: Proven ability to break down and re-architect complex, cross-functional workflows across IT and business functions
- Core Competence: Deep proficiency in Identity Management (Okta) and/or Endpoint Management (Jamf Pro, Intune)
- Operational Maturity: Experience with ITIL processes or service management principles (ITSM) in a growing organization
- L3 Ownership: The ability to translate ambiguous and complex asks into well-defined objectives and deliverables.
Okta, Okta Workflows, Retool, FreshService (ITSM), Google Workspace, Slack, MDM (Jamf Pro, Kandji, Intune), Airtable, AWS/GCP, Rippling (HRIS)
The target salary range for this position is $160,000 - $190,000. Individual compensation for this role will depend on various factors, including qualifications, skills, and applicable laws. In addition to base compensation, this role is eligible to participate in our equity incentive and competitive benefits plans, including but not limited to: flexible PTO, Medical/Dental/Vision plan options, 401(k), Teladoc Health and more.
Please be aware of recent job scam attempts. Our recruiters use getgarner.com email domain exclusively. If you have been contacted by someone claiming to be a Garner recruiter or a hiring manager from a different domain about a potential job, please report it to law enforcement here and to [email protected].
Equal Employment Opportunity:Garner Health is proud to be an Equal Employment Opportunity employer and values diversity in the workplace. We do not discriminate based upon race, religion, color, national origin, sex (including pregnancy, childbirth, reproductive health decisions, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, genetic information, political views or activity, or other applicable legally protected characteristics.Garner Health is committed to providing accommodations for qualified individuals with disabilities in our recruiting process. If you need assistance or an accommodation due to a disability, you may contact us at [email protected].
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What We Do
Garner Health is a health tech startup that is transforming the healthcare economy by enabling patients to receive high-quality and affordable care. Garner Health has two core offerings: Garner, a benefit program that uses a new approach to data science and incentive accounts to help employees find the best doctors in their communities, and Garner DataPro, a provider recommendation platform that serves referrals based on the most accurate provider performance and directory data in the industry. Garner Health’s offerings utilize over 75% of the medical claims data in the United States to objectively examine patient outcomes based on more than 500 specialty-specific quality and efficiency measures. By analyzing millions of healthcare journeys across 82 distinct medical specialties, Garner Health sets a new industry standard in delivering reliable, actionable referrals and navigating patients to the highest-quality providers. Garner Health is a remote-first company based in NYC.
Why Work With Us
Our values connect us in caring deeply about doing something different and hard — transforming the healthcare economy. They create an actionable set of norms for how we operate, including how we make decisions and support one another. Learn about our values here: https://www.getgarner.com/about.
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