Devoted Health

Manager

• Manage issue resolution, ensuring timely and effective responses to provider concerns while enhancing satisfaction and trust.
• Spearhead efforts to build a new process to centralize the centralization of provider issue intake, to improve efficiency across the organization.
• Lead initiatives to identify, charter, and execute upstream operational improvements, proactively tackling challenges before they escalate and transforming our operational landscape.
• Develop and implement tools to accelerate and scale our ability to deliver actionable insights, enhancing data visibility and empowering our ability to make informed decisions.
• Meet with providers to resolve escalations and deliver proactive performance insights, actively engaging to understand their needs and challenges.

Senior Manager – Provider Escalation & Education

Operations

• Report to the Senior Manager, Practice Operations.
• Oversee day to day activities and support healthcare operations by overseeing policy adherence, process improvement, and claims management.
• Monitor key metrics and analyze trends.
• Lead cross-functional projects and develop training and documentation.
• Provide billing and denial management support while collaborating with clinical staff and leadership to ensure compliance and efficiency.

Senior Associate, Operations

Director

• Interface directly with providers , particularly health systems, on claims policies and claims disputes.
• Lead our Payment Policy Committee (PPC) and serve as our lead expert on claims and payment regulations, offering policy and implementation recommendations that are compliant and balance commercial, relationship, and operational goals
• Serve on our Contract Committee and review all provider contracts brought to the Committee, flagging any non-favorable, vague, non-compliant, or operationally unfeasible payment terms.
• Review complex claims, making clear and reasonable adjudication decisions while also setting policy and precedence for other similar claims.

Claims & Payments Director

• Identify and research new medical cost savings opportunities
• Develop innovative payment integrity concepts and programs
• Leverage subject matter expertise to research opportunities for cost savings and improved claim accuracy
• Design and build the operational workflows necessary to implement new programs from the ground up
• Bring new concepts to life as a hands-on operator by building workflows and processes to support them
• Work closely with a variety of internal teams to understand the root cause of payment inaccuracies and drive program success
• Effectively manage multiple projects and priorities, from initial concept to full implementation

Program Development Manager, Payment Integrity

Sales

• Recruitment, development, management and success of sales team comprised of Broker Managers, Community Outreach Specialists, and administrative staff
• Be out in the field with the sales team building relationships with prospects, providers, and community influencers
• Create and execute upon a sales strategy
• Ensure market adherence to Medicare guidelines and compliance regulations
• Oversight and success of the contracted external agent channel on a local level
• Achievement of sales goals and retention expectations
• Collaboration with internal and external stakeholders to achieve intended results
• Balance time in the field with administrative duties including reporting, budget tracking, meetings with leadership and other departments

Sales Director

Bilingual

• Be the primary support for members across inbound calls, outbound outreach, and digital platforms (chat, secure messaging, email, video)
• Engage members with empathy and professionalism across calls and digital channels
• Build high-quality connections that create trust and empower members to take confident steps in their care
• Translate complex benefits and healthcare information into simple, clear terms
• Flex between inbound service, outbound engagement, and digital outreach as priorities evolve
• Adhere to HIPAA compliance and all regulatory requirements to protect member privacy and ensure high-quality service
• Master multi-tasking skills: listen to members, talk and type simultaneously
• Work assigned 8.5 hour shifts within stated Call Center hours
• Must be hard wired via ethernet cable into your internet router

Bilingual Member Service Guide, Spanish

• Devoted Health mission: dramatically improve the health and well-being of older Americans by caring for every person like family
• Development, maintenance and management of an adequate provider network in assigned geographical area
• Maintaining relationships and all provider relations activities in assigned geographical area
• Negotiating and renegotiating contracts with providers as assigned
• Engage internal subject matter experts and providers to identify opportunities to improve provider/member cost and quality performance
• Monitoring of various reports to ensure all necessary compliance requirements are met and maintained
• Reporting to leadership current status, risks, and potential opportunities in area of responsibility on a regular basis
• Supporting the overall Network Team as required and supporting assigned groups to improve performance in CMS STAR measures

Provider Network Manager

• At Devoted Health, ensure provider claims are paid correctly, on time, and per contract to reduce waste and errors.
• Identify and research new medical cost savings opportunities to improve claim payment accuracy and reduce medical spend.
• Assess opportunities via policy research, industry trends, claims performance analysis, and cross-functional collaboration.
• Analyze medical cost trending, claim processing trends, overpayments, and other irregularities to develop payment integrity programs.
• Create and iterate datasets, develop data insights, and build opportunity sizing models to estimate financial impact and ROI.
• Partner with Clinical & Policy SMEs to validate findings against medical necessity and regulatory requirements.
• Maintain and prioritize a concept backlog; score and rank concepts using structured criteria.
• Monitor CMS updates, OIG/RAC findings, and industry trends to identify emerging risk areas and incorporate external benchmarks.

Senior Manager, Payment Integrity Program Development

• Clinical Associate in interdisciplinary virtual and home based (house calls + telehealth) medical practice called Devoted Medical
• Liaison between healthcare services and Devoted members, supporting clinicians and coordinating care across PCPs, pharmacies, DME, home health, imaging, lab testing
• Pre-visit prep, video onboarding, post-visit prep, order management/care coordination, triage support, patient education
• Support includes coordinating DME and skilled nursing services, arranging lab/imaging, notifying members of lab results and coordinating follow up, collecting medical records, setting and confirming appointments
• Follow up post ER and Dispatch Health visits, review internal program referrals, send welcome kits and educational materials
• May include occasional weekend hours through optional overtime

Clinical Associate, Bilingual

Vice President

• This position is remote and must reside in NYC area.
• Responsible for network development and management along with servicing for an assigned geographic area.
• Development, maintenance and management of an adequate provider network in assigned geographical area.
• Maintaining relationships and all provider relations activities in assigned geographical area.
• Negotiating and renegotiating contracts with ALL provider types as assigned.
• Monitoring reports to ensure compliance requirements are met and maintained.
• Reporting to leadership on current status, risks, and potential opportunities.
• Support of overall Network Team as required to achieve success of Devoted Health.

Vice President, Network Development

Business Intelligence Developer

• We’re on a mission to change healthcare — how it’s paid for, delivered, experienced.
• We want to put people center stage, not process or profit; treat Medicare members like family with loving care.
• We’re gathering smart, diverse, big-hearted people to create a new kind of healthcare company — one that combines compassion, health insurance, clinical care, and technology.
• We aim to build a health plan and clinical services to give seniors easy access to high-quality care.
• Role: Principal BI Analyst partnering with pharmacy leadership to leverage data to inform business strategies, focusing on Medication Adherence data insights.
• Reports to Data Organization; partner with cross-functional teams; build tools for data integrity, Looker, and scaling with LLM-based analyses.
• Responsibilities include root cause analysis, KPIs design and ownership, dashboards, data governance, proactive monitoring, and communicating findings.
• Collaborate with Product, Data Science, and Engineering to support data warehousing in Snowflake or internal platform.
• Designing data structures and tools that scale with LLM-based analytics including conversational analytics.
• Attributes to success: curiosity, learning mindset, collaboration, communication, and ability to work across functions.