Devoted Health

Bilingual

• 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

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

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

• 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

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.

Clinical Associate, Bilingual

Senior Manager, Payment Integrity Program Development

Vice President, Network Development

Provider Network Manager

Principal Business Intelligence Analyst - Medication Adherence