Note: The job is a remote job and is open to candidates in USA. Pivotal Health is a technology platform that helps healthcare providers navigate complex reimbursement workflows and recover underpaid claims. The Associate Manager, State Arbitration Operations will lead a four-person production team, manage state arbitration and negotiation workflows, establish repeatable processes, and support expansion into additional state markets.
Responsibilities
- 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
Skills
- 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 workflow oversight for direct reports. This is a people-management role, not a growth opportunity into management for the first time
- Comfortable with manual, hands-on production work as a core part of the job, not just something to automate away
- Experience working with payer disputes, healthcare negotiations, or arbitration processes
- Strong analytical skills and comfort working in Google Sheets / Excel to manage case workflows and operational tracking. 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 in RCM organizations or provider groups managing payer disputes
- Experience working with IDR under the No Surprises Act
- Familiarity with operational tools such as Asana, Notion, or similar systems
- Experience helping launch or operationalize new programs or workflows
- Candidates must be authorized to work in the United States without current or future employer sponsorship
- Experience working with state arbitration processes (Texas, Ohio, or Georgia experience a plus)
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
- Remote and hybrid flexibility varies by role and team, and is outlined in each job description.
Company Overview