Pivotal Health

Analyst

• Serve as the go-to contact for Client Success on eligibility questions, handling tickets, calls, and payor outreach
• Act as the first point of intake for payor eligibility inquiries
• Pull claims data to identify root causes
• Review payor, internal, and IDRE eligibility flags and determine whether claims are truly ineligible, product defaults requiring correction, or payor flags to dispute
• Communicate clear eligibility determinations to Client Success
• Document recurring default-Ineligible patterns and work with Product on corrective actions
• Build Client Success-facing materials explaining IDR eligibility and responses to payor-specific questions
• Define handling and escalation processes for disputed eligibility flags, including payor outreach and legal escalation
• Build and own eligibility-risk dashboards in Metabase or Power BI
• Monitor recurring themes and identify eligibility problems before filings are submitted
• Establish the ineligible claims review process and help shift eligibility detection from reactive to proactive

Optimization Analyst, Eligibility Focus

Accounts Payable

• Run the weekly fee-refund upload for won or ineligible IDR cases, matching remit amounts against received bricks and escalating discrepancies to Finance
• Serve as the primary contact for Client Success refund inquiries, tracking missing or delayed refunds using Metabase and the dispute status tool
• Build and maintain relationships with Independent Dispute Resolution Entities to expedite outstanding refunds owed to practices
• Drive communications between Client Success, IDREs, Business Operations, and Accounting
• Establish and drive new processes to meet evolving business and customer needs
• Maintain and improve Payor Compliance SOPs as workflows evolve
• Identify patterns in payment and refund exceptions that indicate systemic issues and escalate them
• Identify platform errors where lost disputes are marked as wins and escalate them to Engineering with supporting evidence
• Reconcile payments and refunds, identify structural payment blockers, and support payment processing through the manual intervention queue

Accounts Payable Analyst

Implementation Specialist

• Own client implementations end-to-end from Sales handoff through kickoff, SFTP and claims data setup, configuration, launch readiness, go-live, and handoff to Client Success
• Independently manage project plans, timelines, dependencies, and launch readiness
• Configure SFTP access and client settings, confirm claims file receipt, and perform initial file validation
• Partner with Engineering on pipeline enablement, ingestion failures, and advanced troubleshooting
• Manage physician group implementations and complex health system rollouts
• Run kickoffs, working sessions, status updates, and client communications
• Set time-to-value timelines and address blockers before they affect launch schedules
• Coordinate training and readiness checks and document configuration, data requirements, open items, and key contacts
• Partner with Product, Engineering, Sales, and Client Success to resolve dependencies
• Identify recurring issues, recommend process improvements, update documentation, and implement agreed changes
• Partner with the Implementation Lead on complex health system implementation approaches and independently manage day-to-day delivery
• Help automate manual implementation processes

Senior Implementation Manager

IT Support

• Serve as the first point of contact for IT support in person in NYC and remotely for other employees
• Own the FreshService help desk, establish Slack-based triage, create self-service documentation, troubleshoot macOS and Windows hardware and software, and track recurring issues
• Manage onboarding, offboarding, employee accounts, and application access through Rippling
• Partner with People Ops on the new-hire pipeline and device timing
• Purchase and provision laptops, monitors, and peripherals
• Maintain device inventory and office spare-hardware records
• Plan hardware needs against the hiring plan
• Maintain conference room technology across New York and Los Angeles, including daily room checks
• Support Zoom and Google Meet and standardize meeting rooms on one platform
• Maintain office networking and Wi-Fi with the network vendor
• Act as the on-site technology lead for the new NYC office
• Administer Google Workspace, Slack, Zoom, Notion, Microsoft 365, Asana, Linear, and GitHub
• Manage software licenses, monitor usage, and conduct regular access reviews
• Manage outsourced IT and other IT vendors, deciding what to handle internally and what to escalate
• Partner with the Security Platform team on device compliance, access reviews, and security awareness rollouts

IT Manager

Engineering Manager

• Lead the Case Strategy Engineering team
• Own engineering outcomes that improve incremental reimbursement delivered to customers and connect the technical roadmap to customer value and ARR
• Own data models, databases, APIs, services, and full-stack workflows applying case strategies throughout the IDR process
• Partner with Science and AI Platform teams to move AI and ML capabilities from experimentation into reliable product experiences
• Build systems that capture outcomes, surface signals, and feed real-world results into model development and strategy improvement
• Set priorities, coach engineers, create accountability, and support rigorous technical debate
• Hire engineers and establish organizational roles, ownership boundaries, and operating practices
• Turn ambiguous product and technical problems into plans, sequence work, manage dependencies, and ensure consistent delivery
• Guide architecture across Python services, GCP infrastructure, data systems, LLM-enabled capabilities, and customer-facing applications
• Use AI-enabled development tools to explore ideas, prototype solutions, and contribute directly when useful
• Report to the Director of Product Engineering

Optimization Analyst, Eligibility Focus

Accounts Payable Analyst

Senior Implementation Manager

IT Manager

Engineering Manager, Case Strategy