Senior Manager, Business Operations
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
We’re looking for a Senior Manager, Business Operations to own and scale the operational engine that powers Pivotal Health.
This is a high-impact role for an experienced operator who thrives in ambiguity and knows how to build systems that scale. You’ll take ownership of throughput, quality, and execution across our upstream workflows through IDR filing, ensuring operations remain accurate, efficient, and resilient as volume grows.
You’ll partner closely with downstream fulfillment, Customer Success, Finance, Product, and Engineering to improve handoffs and eliminate friction. You’ll also manage and develop a growing team of analysts, helping leadership shift from day-to-day execution toward long-term strategy.
This role is for someone who enjoys building structure where it doesn’t exist yet — and raising the bar as they go.
What You’ll Do
Own and scale core operations: Take accountability for day-to-day operational performance, including throughput, quality assurance, and continuous improvement of core workflows. Identify bottlenecks and proactively implement durable solutions.
Design processes that scale: Build and optimize workflows that support increasing volume without sacrificing accuracy. Reduce rework through better documentation, tooling, and system design
Lead and grow a team: Manage and develop a team of analysts, with plans to scale over time. Set clear expectations, provide coaching, and foster a culture of accountability and collaboration.
Use data to drive decisions: Own key operational KPIs and reporting. Analyze trends, surface risks, and prioritize improvements based on measurable impact.
Partner cross-functionally: Work closely with Product and Engineering to inform system enhancements. Align with Customer Success, Finance, and fulfillment teams to ensure smooth operational handoffs.
Operate in ambiguity: Take initiative in evolving environments where problems aren’t fully defined. Propose solutions, execute with minimal oversight, and build structure as you go.
Who You Are
5+ years of experience leading complex operations in fast-paced or scaling environments
Experience hiring, developing, and organizing teams in scaling environments
Strong analytical skills with advanced Excel proficiency
Comfortable operating in ambiguity and making decisions with imperfect information
Highly organized with strong attention to detail and ability to manage multiple workstreams
Clear communicator who can distill complex operational concepts into actionable insights
Collaborative partner across Product, Engineering, Finance, and customer-facing teams
Familiarity with SQL or willingness to learn quickly
Extra Credit Experience
Experience in health-tech, revenue cycle management (RCM), IDR, fintech, finance, or consulting
Experience building operational systems from the ground up in early-stage or scaling companies
Exposure to regulated or compliance-heavy environments
Why You'll Love the Role
Real ownership over core operations: You won’t inherit a perfectly built machine. You’ll help define and scale it. The systems you design will directly shape how the company operates.
High-leverage impact: This role sits at the center of throughput, quality, and execution. The improvements you drive will unlock capacity across teams and directly influence company performance.
Cross-functional influence: You’ll partner closely with Product, Engineering, Finance, Customer Success, and leadership. Your insights won’t sit in a dashboard — they’ll drive decisions.
Build while scaling: We’re in a growth phase. That means complexity, evolving processes, and real opportunity to create durable structure where it doesn’t yet exist.
Leadership with room to grow: You’ll manage and develop a team while shaping how the function evolves. This is a chance to step into broader operational leadership as the company scales.
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.