Senior IT Systems Engineer

Senior IT Systems Engineer

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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.

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.

• 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, App Smith, 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, Fresh Service (ITSM), Google Workspace, Slack, MDM (Jamf Pro, Kandji, Intune), Airtable, AWS/GCP, Rippling…