About the Role

Pivotal Health is looking for a Principal Client Success Manager to own our most complex and highest-value relationships-including multi-hospital health systems and enterprise providers-and to set the standard for how we serve them. This is our most senior individual-contributor role in Client Success: a seat for someone who wants to stay close to the work, be the trusted advisor in the room with revenue cycle leaders, and raise the bar for the whole function without stepping into people management.

You'll manage a focused book of strategic accounts, guiding health systems through the No Surprises Act / IDR dispute process and turning complex billing, claims, and reimbursement workflows into measurable outcomes. You'll be a 01 builder where it counts-developing the playbooks, frameworks, and systems that scale how we operate, while staying nimble and hands-on as we grow into larger, more complex health systems.

What You'll Do

• Own and grow a focused portfolio of Pivotal's largest and most strategic health system accounts (multi-hospital systems and enterprise providers) with a focus on retention, expansion, and long-term partnership success.
• Serve as a trusted strategic advisor to revenue cycle leaders and executive stakeholders within health systems, articulating value and ROI and building the relationships that anchor multi-year partnerships.
• Guide clients through the No Surprises Act / IDR dispute process, translating complex billing, claims, and reimbursement workflows into clear, measurable outcomes.
• Define what 44good45 looks like across account management, communication, and follow-through, building the playbooks, glossaries, and shared frameworks that create consistency across the team.
• Act as the voice of the client, synthesizing feedback, patterns, and friction points across your accounts and translating them into clear insights for Product, Engineering, and Operations.
• Read and interpret account-level data (dips, spikes, and trends) to understand the 44why,45 and turn analytics into narrative, recommendations, and action.
• Lead strategic account planning and QBRs, partnering closely with Sales to identify and advance expansion opportunities across your portfolio.
• Step into the most complex and sensitive client situations as a senior individual contributor, resolving issues quickly, calmly, and effectively.

What We're Looking For

• 5-10+ years in a client-facing role such as Client Success, Account Management, or client-facing strategy/consulting; experience in healthcare, health tech, or IDR strongly preferred.
• Deep healthcare revenue cycle experience (RCM, payer/provider, or health systems), ideally including No Surprises Act / IDR, billing, claims, and reimbursement.
• Proven ability to manage complex, high-value, strategic accounts-ideally across multiple hospitals or health systems rather than a single account.
• Exceptional communication and executive presence, with the ability to influence and build trusted relationships with C-level and revenue cycle leaders and translate complex insights into clear strategy.
• Comfortable working with data, reporting, and account-level analytics, with the ability to interpret trends and build a compelling, data-backed story.
• AI-literate, with a builder's instinct for creating systems, playbooks, and deliverables quickly.
• Highly organized with strong operational discipline (CRM, workflows, forecasting).
• Comfortable operating in ambiguity and a fast-moving environment where priorities shift and ownership is expected.
• This is an individual-contributor role with no direct reports; you'll lead through influence, expertise, and example rather than by managing a team.

Extra Credit Experience

• Experience at an early-stage or scaling company.
• Management consulting background-having run revenue cycle projects, operated on-site at hospitals, or worked directly with revenue cycle leaders in a health system.
• Experience building or evolving a Client Success function.
• Background in operations, analytics, or strategy.

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.

Benefits Include:

• Competitive compensation, including equity
• Full health, dental, and vision coverage
• Retirement savings plan through 401(k)
• Flexible time off
• Opportunities for company-wide connection and events

Ready to Make an Impact?We're building something meaningful; and we want you on the team.

Bring your ideas, curiosity, and drive, and let's transform healthcare reimbursement together.

Employment Information

Work Authorization

Candidates must be authorized to work in the United States without current or future employer sponsorship.