Title: Senior Manager, Business Operations

Location: New York City, NY (hybrid)

Reporting Structure: Vice President of Business Operations

Company Description

Healthcare reimbursement is broken—too complex, too opaque, and too often unfair to the providers delivering care and the patients receiving it.

Pivotal Health exists to fix that. We build technology that helps hospital-based providers get paid fairly for the care they provide, while protecting patients from surprise medical bills. Our platform guides providers through the highly complex No Surprises Act dispute process, turning what was once manual, risky, and inconsistent into a structured, data-driven workflow.

With a rapidly growing customer base, strong revenue momentum, and a mission rooted in fairness and transparency, Pivotal is helping modernize one of healthcare’s most critical—and overlooked—systems.

As our Senior Manager, Business Operations, you will:

Play a critical role in owning and scaling Pivotal Health’s core business operations. This is a highly impactful role for an experienced operator who thrives in ambiguity, enjoys building and optimizing processes, and leads teams through growth and change.

You will take ownership of operational throughput, quality, and execution across upstream workflows (through IDR filing), while partnering closely with downstream fulfillment, Customer Success, Finance, Product, and Engineering. This role will also manage and develop a growing team of analysts, allowing senior leadership to shift out of day-to-day execution and focus on strategic priorities.

Key Responsibilities

Operational Ownership & Scale

• Own day-to-day operational performance, including throughput, quality assurance, and continuous improvement of core workflows.
• Design, optimize, and scale operational processes to support increasing volume without sacrificing accuracy or quality.
• Identify bottlenecks, inefficiencies, and sources of rework, and proactively implement solutions.

People Management & Leadership

• Manage and develop a team of at least 2 analysts, with plans to scale the team further over time.
• Set clear expectations, define responsibilities, and support growth and development through coaching and feedback.
• Foster a collaborative, respectful team culture focused on problem-solving and shared ownership.

Process Design & Improvement

• Analyze operational data to uncover trends, risks, and opportunities for improvement.
• Reduce administrative errors and rework through better process design, documentation, and tooling.
• Partner cross-functionally with Product and Engineering to inform system and workflow enhancements.

Metrics & Performance Management

• Own and track critical operational KPIs, ensuring consistent monitoring and improvement.
• Use data to make informed decisions, prioritize initiatives, and measure impact over time.

Cross-Functional Partnership

• Work closely with Customer Success, Finance, Product, and downstream fulfillment teams to ensure smooth handoffs and alignment.
• Serve as a key operational partner to leadership, regularly surfacing insights, risks, and recommendations.

Ambiguity & Problem Solving

• Operate effectively in an evolving environment where not all problems are fully defined.
• Take initiative to identify issues, propose solutions, and execute with minimal oversight.
• Scale intelligently to build durable, high-quality operations.

Is This You? 

• 4–6+ years of experience leading complex operations in fast-paced or scaling environments.
• Proven experience managing and developing teams with the ability to scale leadership as the team grows.
• Strong analytical skills with advanced Excel proficiency; ability to manage, analyze, and present operational data clearly.
• Comfort operating in ambiguity, with a demonstrated ability to make decisions using incomplete information.
• Excellent organization and attention to detail, with the ability to manage multiple work streams simultaneously.
• Strong communication skills, including the ability to distill complex operational concepts into clear written and verbal updates.
• Collaborative mindset with experience partnering cross-functionally across Product, Engineering, Finance, and Customer-facing teams.
• Familiarity with SQL or a willingness to learn quickly is a plus.
• Prior experience in health-tech, revenue cycle management (RCM), IDR, fintech, finance, or consulting is a bonus, but not required.

#Perks

• Compensation: $130-165k annual salary.
• Opportunity to take on significant responsibility and have a direct impact on how the company scales.
• A collaborative, mission-driven work environment where your ideas are valued and acted on.
• Full medical, dental, and vision insurance coverage.
• 401(k).
• Office with casual vibes in Manhattan.
• Periodic in-person team gatherings and offsites, bringing together teammates from across the company to connect, collaborate, and celebrate.

Note: Unfortunately, we are unable to sponsor visas at this time.