Senior Manager, State IDR

Pivotal Health

Senior Manager developing and leading state arbitration strategies at Pivotal Health. Streamlining complex reimbursement processes in the healthcare industry.

Posted 7/13/2026full-timeRemote • New York • 🇺🇸 United StatesSenior💰 $150,000 - $170,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in managing state arbitration strategies and processes, with a strong focus on Revenue Cycle Management and operational leadership. Capable of building structured workflows and leveraging data analytics to drive decision-making and team performance.

Highest-signal resume keywords

State Arbitration ManagementRevenue Cycle ManagementData AnalysisTeam LeadershipProcess Development

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Operational ManagementWorkflow DevelopmentData AnalysisSQLExcel

Soft Skills

Strategic ThinkingCommunicationTrust BuildingProblem Solving

Tools & Technologies

AI Tooling

Industry Keywords

Payor LandscapeIDR EntitiesState Filing ProcessClaims Management

Tech Stack

Tools & technologies

SQL

About the role

Key responsibilities & impact

Own state arbitration strategy end to end. Decide which states we pursue, in what order, and why. Turn a function that's been informal and reactive into a deliberate, prioritized roadmap.
Build the state filing process from the ground up. Formalize how, when, and where we file across the ~20 states with real volume, replacing ad hoc handling with a repeatable operating model.
Lead and grow the State Arbitration team. Take over management of the existing team, including direct oversight of state arbitration staff, and hire quickly to scale the function as it formalizes.
Recover misrouted claims. Identify volume currently flowing into the federal IDR process that should be filed at the state level, and build the workflows to catch and correctly route it going forward.
Partner with Data & Analytics. Work closely with the analytics team to surface trends in claims and outcomes, and use that data to sharpen which states and strategies we invest in.
Drive the product roadmap for state arbitration. Partner with Product and Engineering to translate operational reality (eligibility rules, filing requirements, remittance advice complexity) into the tools and automation the team needs.
Own remittance advice and eligibility determination. Bring clarity to where claims sit between federal and state processes, and build the judgment calls into scalable, documented logic rather than one-off decisions.
Take on broader department management. Assume ownership of responsibilities currently held by Operations leadership, running state arbitration as its own accountable department rather than a shared responsibility.

Requirements

What you’ll need

8–10 years of progressive management experience, with real depth in Revenue Cycle Management or an adjacent industry
Experience managing operational or administrative teams, not just corporate or credentialed hires
A track record of walking into ambiguity and building structure
Working knowledge of the payor landscape, state arbitration, and IDR entities
Comfortable with Excel and data analysis; SQL and AI tooling experience is a strong plus
Open, honest, and direct: you over-communicate by default and you trust your team while still verifying the work
A strategic thinker who's equally willing to be hands-on when a process needs to be built or rebuilt from scratch

Benefits

Comp & perks

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