Claims Operations Manager – Refund Management

Devoted Health

Claims Operations Manager leading modernization of the provider refund ecosystem at Devoted Health. Focused on compliance, operational efficiency, and performance governance with cross-functional collaboration.

Posted 5/20/2026full-timeRemote • 🇺🇸 United StatesMid-LevelSenior💰 $73,000 - $125,000 per yearWebsite

Tech Stack

Tools & technologies

Tableau

About the role

Key responsibilities & impact

Lead the end-to-end modernization of the provider refund ecosystem.
Design and deploy the 'future state' of our refund processing engine, leveraging automation to eliminate manual touchpoints.
Act as a hands-on operator by taking our internal toolkit—including AI, automation, and data platforms—and deploying them to hit specific recovery outcomes and performance targets.
Define and own the 'Source of Truth' for program health.
Build and manage BI dashboards to track recovery trends.
Own the integrity of the program by building processes that ensure 100% compliance with CMS regulatory timelines and internal standards.
Act as the primary liaison between Payment Integrity, Finance, and Product to close feedback loops on overpayment root causes, preventing leakage before it starts.

Requirements

What you’ll need

Bachelor’s degree required, or equivalent experience in a high-growth or regulated environment.
Proven ability to use complex data sets to drive performance and influence organizational outcomes.
Proficiency with BI platforms (e.g., Snowflake, Looker, Tableau) and a track record of using LLMs or automation to solve business problems.
Ability to translate complex technical or financial concepts into actionable plans for any audience.
An elite eye for detail with the ability to pivot between tactical 'in the weeds' tasks and high-level goal alignment.
Background in healthcare technology, management consulting, or tech-ops where you thrived by delivering results in ambiguous environments.
Success in becoming an SME in complex tools or regulatory frameworks to drive better business outcomes.
Experience building collaborative, performance-driven relationships with cross-functional partners and offshore teams.

Benefits

Comp & perks

Employer sponsored health, dental and vision plan with low or no premium
Generous paid time off
$100 monthly mobile or internet stipend
Stock options for all employees
Bonus eligibility for all roles excluding Director and above; Commission eligibility for Sales roles
Parental leave program
401K program
And more....

ATS Keywords

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Hard Skills & Tools

data analysisautomationBI dashboard developmentLLMsperformance metricscompliance managementrefund processingprogram health managementdata set utilizationprocess design

Soft Skills

communicationattention to detailcollaborationproblem-solvinginfluenceadaptabilitytactical executiongoal alignmentrelationship buildingleadership