Pivotal Health is the leading technology platform that helps healthcare providers get paid fairly in an increasingly complex reimbursement landscape.
Today, many providers face persistent underpayment from health insurance companies, despite delivering high-quality care. While processes like IDR (Independent Dispute Resolution) were designed to promote fairness, they’re often administrative-heavy, time-consuming, and difficult to navigate without the right tools.
Pivotal Health combines software, data, and service into a seamlessly integrated, AI-driven platform that simplifies these complex reimbursement workflows. We help providers efficiently dispute underpaid claims, reduce administrative burden, and recover the reimbursement they’re entitled to; without adding more work to already stretched teams.
Our full-service IDR solution is just the starting point. We’re building solutions that enable providers to operate with clarity, control, and confidence across the reimbursement journey.
We’re looking for an Associate Manager, State Arbitration Operations to help build and operationalize Pivotal’s emerging state dispute resolution function.
Today, our team supports federal Independent Dispute Resolution (IDR) under the No Surprises Act. As we begin exploring state-level arbitration processes, we’re looking for someone who can help establish the workflows, documentation, and operational structure needed to support these programs.
Each state operates under its own rules, timelines, and negotiation processes. Some involve structured filing workflows, while others rely heavily on manual negotiation and email-based communication with health plans. This role will help navigate that complexity, starting with Texas arbitration, and support the development of repeatable processes as the program evolves.
This is a great opportunity for someone with experience in payer disputes, healthcare arbitration, or revenue cycle management (RCM) who enjoys building structure in new operational areas.
Help build the state arbitration function: Support the development of Pivotal’s state arbitration workflows, starting with Texas, and help establish operational processes that enable the team to scale into additional states.
Manage state negotiation workflows: Review and respond to health plan communications, evaluate settlement offers, and manage negotiation timelines to ensure disputes progress through state arbitration processes.
Create repeatable processes: Document workflows, establish operational guidelines, and improve systems that support the state arbitration program.
Support expansion into additional states: Research and operationalize processes for new state arbitration programs as the team evaluates where to expand.
Oversee day-to-day operations: Provide guidance to dispute resolution coordinators responsible for managing case workflows and ensure disputes are tracked accurately.
Bring structure to an evolving function: Help organize priorities, workflows, and team processes as the state arbitration program continues to grow.
Partner cross-functionally: Collaborate with Product, Engineering, Finance, and Customer Success to ensure state arbitration processes integrate effectively with the broader dispute lifecycle.
4+ years of experience in healthcare operations, revenue cycle management (RCM), payer disputes, or arbitration workflows
Experience managing or leading a team, either as a people manager or team lead responsible for coaching, workflow oversight, or performance management
Experience working with payer disputes, healthcare negotiations, or arbitration processes
Strong analytical skills and comfort working in Google Sheets / Excel to manage case workflows and operational tracking
Experience managing structured operational processes, deadlines, and case-based workstreams
Ability to bring clarity and organization to complex or evolving operational environments
Strong written communication skills when negotiating or corresponding with health plans
Experience working with state arbitration processes (Texas strongly preferred)
Experience in RCM organizations or provider groups managing payer disputes
Experience working with IDR under the No Surprises Act
Familiarity with operational tools such as Asana, Notion, or similar systems
Experience helping launch or operationalize new programs or workflows
We’re a collaborative, low-ego team on a mission to make healthcare reimbursement fairer for providers. While we primarily hire around our core hubs–Los Angeles and New York–we remain open to exceptional talent outside those regions. Remote and hybrid flexibility varies by role and team, and is outlined in each job description.
If you’re excited by solving complex problems and making a real-world impact, we’d love to hear from you.
Benefits Include:
Competitive compensation, including equity
Full health, dental, and vision coverage
Retirement savings plan through 401(k)
Flexible time off
Opportunities for company-wide connection and events
Ready to Make an Impact?
We’re building something meaningful; and we want you on the team.
Bring your ideas, curiosity, and drive, and let’s transform healthcare reimbursement together.
Work Authorization
Candidates must be authorized to work in the United States without current or future employer sponsorship.
Equal Employment Opportunity
Pivotal Health is an Equal Opportunity Employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. We do not discriminate on the basis of race, color, religion, sex, gender identity or expression, sexual orientation, national origin, age, disability, veteran status, or any other legally protected status.
Reasonable Accommodations
Pivotal Health provides reasonable accommodations for qualified individuals with disabilities in accordance with applicable laws. If you need assistance during the application or interview process, please let us know.
Background Checks
Employment is contingent upon successful completion of applicable background checks, where permitted by law.
At-Will Employment
Employment with Pivotal Health is at-will and may be terminated by either party at any time, with or without cause or notice, in accordance with applicable law.