Associate General Counsel

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 mid-level healthcare regulatory attorney from a top law firm or healthcare organization to help with a broad range of regulatory, operational and contracting matters. You’ll own Pivotal’s legal work on provider billing and payer reimbursement disputes, from negotiating directly with health plans to building how we collect on arbitration awards. This work sits close to our revenue, so getting it right matters.

Day to day, you’ll split your time between reactive and proactive work. On the reactive side, you’ll field billing and reimbursement questions, negotiate payment disputes with health plans, and evaluate when a dispute calls for a litigation path. On the proactive side, you’ll partner with our product and operations teams to turn legal judgment into systems, tools, and platform features. Contract review is your second priority, alongside general legal counsel as the business needs it.

This is a role for someone who wants to move from advising on problems to shaping how a company solves them. You’ll apply state and federal law to questions without clean precedent, and you’ll build a legal process where none exists yet.

What You’ll Do

• Partner on payer reimbursement matters.
• Advise on billing and reimbursement questions and set Pivotal’s position in how we approach health plans.
• Drive payment dispute negotiations.
• Negotiate directly with health plans to resolve disputes and recover what providers are owed.
• Build our arbitration award collection playbook.
• Define how we collect on arbitration awards and make the process repeatable as volume grows.
• Shape litigation readiness.
• Evaluate litigation strategies and develop pre-litigation plans so we know when and how to escalate.
• Guide product and operations on regulatory questions.
• Translate healthcare regulatory requirements into the systems, tools, and platform features our teams build.
• Support contract review.
• Review and negotiate vendor agreements, BAAs, NDAs, and MSAs, working alongside the Deputy General Counsel.
• Build a legal process from the ground up.
• Create the workflows and templates a growing legal team needs to scale.
• Counsel the business on general legal matters.
• Serve as a trusted advisor across teams as new questions come up.
• Extra Credit if you Have: HealthTech or healthcare technology experience
• IDR or No Surprises Act dispute work
• Experience working directly with state or federal regulators
• Why You’ll Love This Role
• Direct impact: Your work will power the core systems that help providers get reimbursed quickly and fairly.
• Early-stage growth: You’ll shape backend architecture, engineering processes, and the culture of a rapidly scaling startup.
• Collaborative, low-ego culture: Partner closely with Product, Data, and Ops in a transparent, supportive environment.
• Hybrid flexibility: Offices in LA or NY plus remote flexibility to focus deeply or collaborate in person.
• Ownership and learning: Tackle challenging problems and see your solutions applied to real business outcomes.
• 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.