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Pivotal Health is a technology platform helping healthcare providers navigate complex reimbursement landscapes and dispute underpayment from insurance companies. The company combines software, data, and AI-driven workflows to simplify Independent Dispute Resolution (IDR) and other claim dispute processes.
As Associate Manager of State Arbitration Operations, you will lead a 4-person production team managing state-level dispute resolution workflows across Texas, Ohio, and Georgia, with plans to expand to additional state markets. This role bridges hands-on operational work with team leadership and process development.
Key responsibilities include:
- Managing and developing a team of dispute resolution coordinators, with accountability for quality, throughput, and professional growth
- Reviewing health plan communications, evaluating settlement offers, and managing negotiation timelines
- Documenting workflows and establishing operational guidelines to create repeatable, scalable processes
- Supporting expansion into new state arbitration markets (targeting 15 of 22 potential states within 6 months)
- Tracking cases accurately and ensuring disputes progress through state processes
- Partnering cross-functionally with Product, Engineering, Finance, and Customer Success to integrate state arbitration into the broader dispute lifecycle
- Identifying automation opportunities while prioritizing manual work that must happen now
You bring 5+ years of healthcare operations, revenue cycle management (RCM), payer disputes, or arbitration experience. You have genuine hands-on people-management experience—coaching, performance management, and workflow oversight—and are comfortable doing manual production work as a core part of the role. You're analytical, organized, and skilled at bringing clarity to complex operational environments. Strong written communication for payer negotiations and familiarity with tools like Google Sheets, Excel, and AI tools are essential. Experience with state arbitration processes, RCM organizations, IDR under the No Surprises Act, or operational platforms like Asana or Notion is a plus.
Pivotal Health is a collaborative, mission-driven team focused on making healthcare reimbursement fairer for providers. The company offers competitive compensation including equity, full health/dental/vision coverage, 401(k), and flexible time off.
