Senior IT Systems Engineer

Garner’s mission is to transform the healthcare economy, delivering high-quality and affordable care for all. We are fundamentally reimagining how healthcare works in the U.S. by partnering with employers to redesign healthcare benefits using clear incentives and powerful, data-driven insights. Our approach guides employees to higher-quality, lower-cost care, creating a system that works better for everyone. Patients achieve better health outcomes, employers spend healthcare dollars more effectively, and physicians are rewarded for delivering exceptional care rather than performing more procedures. Garner is one of the fastest-growing healthcare technology companies in the country. Our products are trusted by the most sophisticated employers and providers in the industry, and we are building a team of talented, mission-driven individuals who are motivated to make a meaningful impact on healthcare at scale. About the role: We are looking for an engineer who can walk into messy, cross-functional workflows and turn them into clean, automated systems that scale. This role focuses on identifying high-friction operational processes across the company and replacing them with durable, API-driven automation. You will work across IT, Security, Engineering, and Business teams to reduce manual work, improve reliability, and build systems that scale with the company. This is not a ticket-driven IT role. You will operate with a high degree of ownership, driving initiatives end-to-end from problem discovery through implementation and rollout. 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 (in the Financial District). You must be willing to work in the office 3 days per week on Tuesday, Wednesday and Thursday. What you will do: Identify and automate high-impact operational workflows across onboarding, offboarding, access management, and service delivery Replace manual, fragmented processes with scalable, API-driven systems Build and maintain integrations across HRIS, identity providers, SaaS platforms, and cloud environments Develop internal tools and automation using platforms like Retool, Okta Workflows, and custom scripts or services Apply infrastructure-as-code to manage and version system configurations Incorporate AI into workflows to improve efficiency in areas like ticket routing, knowledge retrieval, and decision support Design and automate access and security workflows that enforce least-privilege and auditability Own and drive cross-functional initiatives end-to-end, from problem definition through implementation and rollout The ideal candidate has: 4–7+ years of experience in IT, platform engineering, automation, or similar roles Strong scripting or programming ability in Python, Go, Node.js, PowerShell, or similar Experience building API-driven automation across multiple systems Ability to design and implement workflows that span multiple tools and teams Experience with infrastructure-as-code such as Terraform or similar A desire to be a part of a high-performing, mission-driven team that operates with intense urgency, a strong sense of individual accountability, and a commitment to authentic feedback What will make you stand out: Hands-on experience with identity and access systems (Okta, SSO, SCIM, RBAC), including implementation and ongoing management Proven ability to build and scale internal tools using platforms like Retool or other low-/no-code solutions Familiarity with security automation and orchestration (e.g., Tines), with an eye toward reducing manual effort and risk Practical experience leveraging AI/LLMs to streamline and enhance operational workflows Strong understanding of compliance and security standards (HIPAA, SOC 2, HITRUST) and how they shape systems and processes Focused on driving meaningful outcomes Able to identify root-cause, system-level issues and desig