Senior Manager, Business Operations

About Pivotal Health

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 a Senior Manager, Business Operations to own and scale the operational engine that powers Pivotal Health.

This is a high-impact role for an experienced operator who thrives in ambiguity and knows how to build systems that scale. You’ll take ownership of throughput, quality, and execution across our upstream workflows through IDR filing, ensuring operations remain accurate, efficient, and resilient as volume grows.

You’ll partner closely with downstream fulfillment, Customer Success, Finance, Product, and Engineering to improve handoffs and eliminate friction. You’ll also manage and develop a growing team of analysts, helping leadership shift from day-to-day execution toward long-term strategy.

This role is for someone who enjoys building structure where it doesn’t exist yet — and raising the bar as they go.

• Own and scale core operations
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  Take accountability for day-to-day operational performance, including throughput, quality assurance, and continuous improvement of core workflows. Identify bottlenecks and proactively implement durable solutions.

• Design processes that scale
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  Build and optimize workflows that support increasing volume without sacrificing accuracy. Reduce rework through better documentation, tooling, and system design

• Lead and grow a team
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  Manage and develop a team of analysts, with plans to scale over time. Set clear expectations, provide coaching, and foster a culture of accountability and collaboration.

• Use data to drive decisions
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  Own key operational KPIs and reporting. Analyze trends, surface risks, and prioritize improvements based on measurable impact.

• Partner cross-functionally
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  Work closely with Product and Engineering to inform system enhancements. Align with Customer Success, Finance, and fulfillment teams to ensure smooth operational handoffs.

• Operate in ambiguity
  :
  Take initiative in evolving environments where problems aren’t fully defined. Propose solutions, execute with minimal oversight, and build structure as you go.

• 5+ years of experience leading complex operations in fast-paced or scaling environments

• Experience hiring, developing, and organizing teams in scaling environments

• Strong analytical skills with advanced Excel proficiency

• Comfortable operating in ambiguity and making decisions with imperfect information

• Highly organized with strong attention to detail and ability to manage multiple work streams

• Clear communicator who can distill complex operational concepts into actionable insights

• Collaborative partner across Product, Engineering, Finance, and customer-facing teams

• Familiarity with SQL or willingness to learn quickly

• Experience in health-tech, revenue cycle management (RCM), IDR, fintech, finance, or consulting

• Experience building operational systems from the ground up in early-stage or scaling companies

• Exposure to regulated or compliance-heavy environments

• Real ownership over core operations: You won’t inherit a perfectly built machine. You’ll help define and scale it. The systems you design will directly shape how the company operates.

• High-leverage impact: This…