Associate Manager, State Arbitration Operations

About Pivotal Health

Pivotal Health is the leading technology platform that helps healthcare providers get paid fairly in an increasingly complex reimbursement landscape.

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 expand into 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 manage a 4-person production team handling this work, starting with Texas, Ohio, and Georgia — which are already operationalized — and support the development of repeatable processes as the program evaluates expansion across additional state markets.

This is a great opportunity for someone with experience in payer disputes, healthcare arbitration, or revenue cycle management (RCM) who is comfortable doing hands-on, manual production work now, while helping the function mature over time.

• Manage the state arbitration production team:
  Lead and develop a 4-person team of dispute resolution coordinators responsible for manual state arbitration and IDR claim filings; drive accountability, quality, and throughput on day-to-day production work.
• 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:
  Help evaluate and operationalize new state arbitration markets as the team works toward decisions across the broader state IDR roster (22 total markets, with a goal of reaching pursue/not-pursue decisions on roughly 15 within 6 months).
• 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, including flagging automation opportunities to Product — without letting those initiatives displace the manual work that needs to happen now.

• 5+ years of experience in healthcare operations, revenue cycle management (RCM), payer disputes, or arbitration workflows
• Genuine, hands-on experience directly managing a team as a people manager — coaching, performance management, and…