Jobs at Devoted Health

The Senior Manager, AI Performance & Operations is responsible for the performance and improvement of AI workflows, incident response, designing evaluation systems, and stakeholder communication.

Provide telephonic and virtual social work case management for high‑needs patients: assess social determinants, develop personalized care plans, coordinate community and clinical resources, support caregivers, facilitate advanced care and palliative/hospice planning, and collaborate with an interdisciplinary team to improve outcomes.

Lead development of AI systems that monitor and evaluate millions of member interactions, drive performance of high-volume voice and chat agents, and build coaching workflows and visualizations to improve frontline and AI agent outcomes. Embed with frontline teams, scale reusable frameworks across functions, and manage a small team of operators and agent builders to ensure adoption and impact.

Lead regulatory compliance activities for Medicare Advantage operations: track and implement regulatory communications, support audits and reporting, perform exclusion screening and entity management, analyze metrics and APCD data, prepare board materials, and support AI initiatives and cross-functional compliance requests to ensure adherence to federal and state requirements.

Manage day-to-day operations of Utilization Management Coordinators to ensure timely prior authorization processing, triage, documentation, and clinical review coordination. Lead and coach staff, monitor performance and compliance with Medicare Advantage and CMS requirements, own AI/LLM-enabled UM workflows and quality metrics, and collaborate cross-functionally to meet SLAs and improve operational efficiency.

Manage day-to-day operations of the Risk Adjustment External Audit program across Retrieval, Evaluation, and Submission workstreams. Improve processes, support cross-functional audit responses, build AI-native KPI monitoring, analyze data, communicate risks and status to stakeholders, and support special projects to drive operational excellence.

Lead and execute end-to-end provider network contracting across Commercial and Medicare Advantage lines. Close complex negotiations with physician groups and ancillary providers, optimize fee schedules and pricing, and operationalize agreements with Provider Ops, Claims, and Credentialing. Build and mentor a high-performing contracting team, standardize playbooks, and leverage AI-assisted tools and data visualization to accelerate deal execution and reporting. Collaborate cross-functionally with Actuarial, Underwriting, Product, and Sales to support market expansion and competitive pricing.

Design and manage the full lifecycle of payment integrity edits and audits, converting CMS, AMA/CPT, and coding regulations into rule logic. Validate hypotheses using data queries, author technical specifications, optimize post-release performance, adopt LLM/AI workflows, map regulatory policy, and coordinate cross-functionally to ensure defensible, efficient claims processing.

Support daily cash management and liquidity across corporate and regulatory entities by processing ACH files, wire transfers, and bank reporting. Reconcile daily bank reports, assist monthly close and audit preparation, maintain treasury documentation, and recommend banking services and controls. Participate in strategic projects and automate treasury processes using AI tools.