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 seeking an exceptional Senior IT Systems Engineer for 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

The ideal candidate has:

• 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
• 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

Technologies we use: 

• Okta, Okta Workflows, Retool, FreshService (ITSM), Google Workspace, Slack, MDM (Jamf Pro, Kandji, Intune), Airtable, AWS/GCP, Rippling (HRIS)

This is a unique opportunity to join a fast-growing company in a transformative role, helping shape the future of healthcare.

Compensation Transparency:

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.