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.

What You'll Do

IDR Subject Matter Expertise

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

IDRE Relationship Management

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

Regulatory Monitoring & Industry Intelligence

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

Industry Engagement & Advocacy

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

Internal Enablement

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

Who You Are

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

Why You’ll Love Working Here

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 company-wide connection and events

• Ready to Make an Impact?
• We’re building something meaningful; and we want you on the team.

Bring your ideas, curiosity, and drive, and let’s transform healthcare reimbursement together .

Employment Information

Work Authorization

Candidates must be authorized to work in the United States without current or future employer sponsorship.

Equal Employment Opportunity

Pivotal Health is an Equal Opportunity Employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. We do not discriminate on the basis of race, color, religion, sex, gender identity or expression, sexual orientation, national origin, age, disability, veteran status, or any other legally protected status.

Reasonable Accommodations

Pivotal Health provides reasonable accommodations for qualified individuals with disabilities in accordance with applicable laws. If you need assistance during the application or interview process, please let us know.

Background Checks

Employment is contingent upon successful completion of applicable background checks, where permitted by law.

At-Will Employment

Employment with Pivotal Health is at-will and may be terminated by either party at any time, with or without cause or notice, in accordance with applicable law.