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 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
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.
Pivotal Health (formerly Radix Health) helps healthcare providers and health systems achieve fair reimbursement through Independent Dispute Resolution under the No Surprises Act.
Our platform combines software, proprietary data, expertise, and AI to manage this complex process end to end, delivering proven results while reducing administrative burden.
We integrate with all major hospital-based RCMs, and support a range of providers organizations, from independent physician groups to established health systems.
Built on transparency, alignment, and results — no fluff, no contract lock-ins, and no commission until after our clients are paid.
