Manager, IDR and Industry Relations

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.

• Serve as an internal expert on Federal IDR requirements, regulations, guidance, and industry trends

• Partner with Client Success and Operations teams to address complex client questions and escalations

• Support client meetings where specialized IDR expertise is needed

• Develop educational materials and guidance for clients and internal stakeholders

• Provide recommendations regarding filing strategy, operational impacts, and emerging regulatory developments

• Own strategic relationships with all major IDREs

• Conduct recurring business reviews with IDRE partners

• Monitor IDRE turnaround times, operational issues, and dispute outcomes

• Serve as Pivotal’s primary point of contact for IDRE-related initiatives and opportunities

• Track CMS guidance, Final Rules, FAQs, court decisions, and other developments impacting the No Surprises Act

• Translate regulatory changes into operational and product recommendations

• Develop summaries and briefings for leadership, clients, and internal teams

• Partner with Product and Operations teams to ensure readiness for future regulatory changes

• Represent Pivotal in industry associations, conferences, and working groups

• Participate in industry discussions regarding NSA implementation and future regulatory developments

• Help strengthen Pivotal’s reputation as a thought leader within the IDR space

• Deliver ongoing education and training to Client Success, Operations, and Product teams

• Build and maintain a centralized repository of IDR guidance and best practices

• Create recurring updates highlighting industry trends and regulatory changes

• Support onboarding and training of new team members

• Deep familiarity with the No Surprises Act and Federal IDR process

• Experience working with healthcare providers, payors, IDREs, or organizations supporting the Federal IDR ecosystem

• Strong written and verbal communication skills

• Experience managing external stakeholder relationships

• Ability to interpret complex regulatory information and communicate it clearly to different audiences

• Highly organized and comfortable managing multiple priorities

• Experience working directly with CMS-related programs or IDRE organizations

• Experience presenting educational content, webinars, conferences, or industry forums

• Healthcare operations, reimbursement, or dispute resolution experience

• Existing relationships within the Federal IDR ecosystem

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…