Healthcare Regulatory Counsel: Payer Reimbursement

Pivotal Health; New York (NY); Hybrid; USD 140,000 - 190,000; Full time

Benefits offered by this job

Equity

Health, dental, and vision coverage

401(k)

Flexible time off

Company-wide events

Job summary

Pivotal Health is seeking a mid-level healthcare regulatory attorney to own regulatory, operational and contracting matters. You’ll work on provider billing, payer reimbursement disputes, and arbitration, collaborating with product and operations to translate regulatory requirements into scalable systems.

You will negotiate with health plans, assess when litigation is appropriate, and help shape the company’s legal processes as the business grows.

Qualifications

• Mid-level healthcare regulatory attorney from a top law firm or healthcare organization
• Own Pivotal’s legal work on provider billing and payer reimbursement disputes
• Experience advising on health plans and arbitration-related matters

Responsibilities

• Partner on payer reimbursement matters and set Pivotal’s position
• Drive payment dispute negotiations with health plans
• Build our arbitration award collection playbook and scale it
• Shape litigation readiness and pre-litigation plans
• Guide product and operations on regulatory questions
• Support contract review with vendor agreements, BAAs, NDAs, and MSAs
• Build scalable legal workflows and templates for a growing team
• Counsel the business on general legal matters across teams

Skills

Regulatory law

Healthcare law

Contract negotiations

Regulatory compliance

Cross-functional collaboration

Job description

Pivotal Health is seeking a mid-level healthcare regulatory attorney to own regulatory, operational and contracting matters. You’ll work on provider billing, payer reimbursement disputes, and arbitration, collaborating with product and operations to translate regulatory requirements into scalable systems.

You will negotiate with health plans, assess when litigation is appropriate, and help shape the company’s legal processes as the business grows.