Title: Client Strategy and Operations Manager

Location: Remote

Reporting Structure: Macie Holstein / Client Strategy and 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.

About the Role

Pivotal Health is looking for a Client Strategy and Operations Manager to own the operational and strategic engine behind our most complex client relationships- large health systems and hospitals. You’ll manage a portfolio of high-value enterprise pods, serving as the strategic and technical owner of how those clients are operated against day-to-day. 

You’ll combine deep data fluency, hands-on technical ownership, and senior client presence to surface issues before clients raise them, turn operational signal into client-facing strategy, and design the playbooks the rest of the team uses as we scale. This is a high-impact, hands-on role at a high-growth startup where your operating decisions will shape how Pivotal scales into the hospital and health system segment. This is an individual contributor role, not a managerial role. 

Responsibilities

• Own end-to-end client operations for a portfolio of large health system and hospital clients- proactively monitoring data, surfacing trends, and resolving issues (file delivery issues, ineligibility spikes, payment anomalies, data quality gaps) before they become client-raised escalations.
• Work closely with implementations teams to understand the nuances and complexity of each clients setup and be the point person after go live for ensuring continued implementation quality
• Use Metabase, BigQuery, and our internal reporting tools to turn operational signal into client-facing strategy: AR aging deep-dives, ineligibility analyses, and executive-ready process recommendations. Build dashboards to surface important information in a timely manner, and then act on it. 
• Serve as a credible strategic counterpart to our Client Success team partners and our clients- walking into every conversation with a recommendation, not just data. You are not just fixing things that break, you are a strategic partner with ideas on how we can move the lever for our clients
• Partner cross-functionally on IDR strategy and payer compliance work, leading special projects across the company and org that push our IDR model forward 
• Mentor analysts on the team, contribute to playbooks and onboarding documentation, and consistently work to improve our internal processes, always focused on building an operating system that lets CS&O scale. 

What We’re Looking For

• 4–6 years in a client-facing operations, strategy, or analytics role such as Client Strategy & Operations, Implementation, or Account Management; experience in either healthtech, RCM, IDR, payer/provider, or healthcare-adjacent enterprise SaaS is required. 
• Direct experience working with or inside large health systems and hospitals is required. You understand how a hospital revenue cycle actually runs, how its data actually flows, and what the nuances to working with health systems are. You bring SME level experience and are excited to take on incorporating your experience into our product. 
• Strong SQL fluency, with comfort in BigQuery (or equivalent) and dashboarding tools like Metabase, Looker, or Tableau. 
• Exceptional communication and presentation skills, with the ability to influence and build trusted relationships with C-level stakeholders and translate complex data findings into one-paragraph executive insights.
• Strategic and proactive mindset, with proven ability to manage high-value accounts, drive measurable outcomes, and mitigate risks before they escalate.
• Demonstrated success leading cross-functional initiatives and complex client implementations, with strong project management and operational excellence skills.
• Experienced mentor and team contributor who thrives in high-growth, fast-paced environments.

Extra Credit Experience

• Experience at a Series A or early-stage startup 
• Experience working with the Independent Dispute Resolution process (IDR)

#Perks

• Competitive compensation, including equity: 
• NYC/LA Hybrid: 140,000-170,000
• All other locations: 120,000-150,000
• Full health, dental, and vision coverage
• Retirement savings plan through 401(k)
• Flexible time off
• Opportunities for company-wide connection and events