Senior IT Systems Engineer

Garnerhealth · New York City, New York · Engineering

Posted 2026-08-07

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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 design durable solutions rather than quick fixes

Comfortable navigating cross-functional environments with competing priorities and constraints

Operates with urgency while building scalable, maintainable solutions

Defaults to automation and efficiency wherever possible

Technologies we use:

Okta, Okta Workflows, Retool, FreshService (ITSM), Google Workspace, Slack, Atlassian (Confluence and Jira), MDM platforms (Jamf Pro, Kandji/Iru, Intune), Airtable, AWS and GCP, Terraform, Rippling (HRIS), SOAR (Tines), and AI-enabled operational tooling (Claude, Gemini, OpenAI)

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

Please note: we are unable to sponsor or take over sponsorship of an employment visa at this time.

Compensation Transparency:

The target salary range for this position is $189,000 - $220,000. 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.

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