Associate Manager, State Arbitration Operations

Job not on LinkedIn

🔥 0 minutes ago

🗽 New York – Remote

🗽 New York – Remote

💵 $85.1k - $110k / year

⏰ Full Time

🟢 Junior

🟡 Mid-level

⚙️ Operations

🚫👨‍🎓 No degree required

👻 Ghost score 20%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Pivotal Health

WebsiteLinkedInAll Job Openings

51 - 200 employees

🏥 Healthcare

💼 Consulting

📦 Logistics

💰 Pre seed on 2024-01

Healthcare • Consulting • Logistics

Pivotal Health is a healthcare technology company that provides the industry’s only full-service Independent Dispute Resolution (IDR) platform, combining software, data, and white-glove services to help providers secure fair reimbursement from payers. Their scalable, integrated SaaS platform automates IDR workflows, connects with major revenue cycle management systems, and manages eligibility, submissions, and appeals on behalf of provider organizations. Pivotal Health serves hospitals and specialty practices with a results-driven, outcome-aligned business model (paid after client success) and emphasizes transparency, high client retention, and measurable revenue recovery.

📋 Description

• Lead and develop a 4-person dispute resolution coordinator team responsible for manual state arbitration and IDR claim filings • Drive accountability, quality, and throughput in day-to-day production work • Review and respond to health plan communications • Evaluate settlement offers and manage negotiation timelines • Document workflows and establish operational guidelines for the state arbitration program • Improve systems supporting state arbitration operations • Help evaluate and operationalize new state arbitration markets • Work toward pursue/not-pursue decisions across the broader state IDR roster, with a goal of roughly 15 decisions within 6 months • Guide dispute resolution coordinators managing case workflows • Ensure disputes are tracked accurately • Organize priorities, workflows, and team processes as the program grows • Collaborate with Product, Engineering, Finance, and Customer Success • Flag automation opportunities to Product while maintaining necessary manual production work

🎯 Requirements

• 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, including coaching, performance management, and workflow oversight for direct reports • Comfortable with manual, hands-on production work as a core part of the job • Experience working with payer disputes, healthcare negotiations, or arbitration processes • Strong analytical skills and comfort working in Google Sheets / Excel • Experience with AI tools • Experience managing structured operational processes, deadlines, and case-based work streams • Ability to bring clarity and organization to complex or evolving operational environments • Strong written communication skills when negotiating or corresponding with health plans • Experience with state arbitration processes is a plus, particularly Texas, Ohio, or Georgia • Experience in RCM organizations or provider groups managing payer disputes • Experience working with IDR under the No Surprises Act • Familiarity with Asana, Notion, or similar operational tools • Experience helping launch or operationalize new programs or workflows • Must be authorized to work in the United States without current or future employer sponsorship

🏖️ Benefits

• 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