Pivotal Health
Manager, IDR and Industry Relations
Part remote, part office, you need to live within commuting distance of a named location.
Hybrid · Williamsburg, NY
Employer listed it 7 weeks ago · Added 5 days ago
Been open since 7 weeks ago. Long-running listings are sometimes left up after the role is filled.
Salary
$130,000 to $160,000
Location
Hybrid · Williamsburg, NY
Timezone
Not stated
Contract
Full-time
Experience
Mid
Category
Operations
Published by the employer
Remote flexibility
Hybrid
This role is only partly remote, the employer expects time in the office around Williamsburg, NY, Remote - US, Hybrid, so you need to live within commuting distance.
What the employer says
- Source listing states candidate location: "Williamsburg, NY, Remote - US, Hybrid"
- Listing mentions "Hybrid"
What Nomaders makes of it
- Not suitable if you plan to move between countries
The quotes above are the employer's own words; the reading is ours. Always check the original listing and employment terms before working from another country.
About the role
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.
About the Role
Pivotal Health is looking for an IDRE Manager to own and professionalize the relationships that sit at the center of our arbitration and reimbursement operations. Independent Dispute Resolution Entities (IDREs) are CMS-approved intermediaries in the No Surprises Act arbitration process, and Pivotal Health currently manages 16+ of these relationships across both federal and state-level arbitration. Today, engagement with IDREs is fragmented; this role will build the structure, cadence, and escalation process needed to manage those relationships proactively rather than reactively.
This is a highly relational, highly organized role. You'll be the person who knows exactly where every dispute sits in the aging cycle, which IDREs are falling out of compliance, and how to get movement, while also translating what you're seeing on the ground into clear, digestible input for Ops, Product, and Engineering so the business can close gaps and improve its processes over time.
What You’ll Do
Own and manage direct relationships with 16+ IDREs, serving as the primary point of contact for escalations, disputes, and day-to-day coordination
Build and run the process for tracking dispute aging, flagging CMS compliance issues (e.g., payment timelines), and escalating with the right IDRE at the right time
Manage a high volume of concurrent IDRE relationships at both the individual case level and the portfolio level
Translate patterns and issues surfaced through IDRE relationships into clear, actionable input for Ops, Product, and Engineering teams; identify gaps, recommend fixes, and propose interim stopgaps while longer-term solutions are built
Work across both state and federal arbitration processes, including IDREs that operate in both
Align internal goals and opportunities to client needs, and help ensure Pivotal Health's approach to IDRE management scales as engagement volume grows
Bring structure, prioritization frameworks (e.g., stack-ranking disputes by age, value, IDRE friendliness, and win/loss rate), and consistent process to a function that is still being built from the ground up
Serve as the IDR & Pivotal operations subject-matter expert in external-facing moments: support complex client questions and escalations, join client meetings that need specialized expertise, develop client education and filing-strategy guidance, and run recurring business reviews with IDRE partners.
What We’re Looking For
Background in revenue cycle management (RCM), healthcare, or management consulting
Experience managing multiple concurrent client or vendor engagements/portfolios simultaneously
Strong relationship management skills. This role is fundamentally relational, not just technical
Comfort with Excel and working with operational/dispute data sets
Strong project and portfolio management skills, with the organizational rigor to track disputes, aging, and escalations across many relationships at once
A get-it-done, feedback-oriented approach that fits a fast-growing, still-forming function
Requirements
The employer hasn't listed requirements separately, they're described in the role summary above and on the original listing.
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
How to apply
- 1Check the flexibility label above, hybrid, matches where you plan to live and work.
- 2Tailor your CV to the role at Pivotal Health, mentioning your remote working experience.
- 3Apply directly on the employer's careers page using the button below. Nomaders never handles your application.
Found 5d ago. Last checked 23 Sept. Always confirm the details on the original posting, salary and location can change after publication.
Listing sourced from Company boards.
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