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Devoted Health

Senior Manager, Business Operations (Payment Integrity)

Reposted 6 Days Ago
Remote
Hiring Remotely in USA
100K-155K Annually
Senior level
Remote
Hiring Remotely in USA
100K-155K Annually
Senior level
Lead and optimize enterprise payment integrity programs (prepay and postpay), translate strategy into operational plans, partner with analytics/finance/tech, monitor KPIs, manage escalations, and reduce payment errors and waste.
The summary above was generated by AI

Job Description

A bit about this role: 

At Devoted, we know that one of the most important ways we will build trust with our network of providers and members  is to pay claims accurately and on time while having transparent payment policies. Our Payment Integrity Department ensures that provider claims are paid correctly by the responsible party, for eligible members, according to contractual terms, not in error or duplicate, and free of wasteful or abusive practices.

As a Senior Manager, you will be the lead architect of these complex operational flows. You will bridge the gap between high-level strategy and tactical execution, managing a multi-layered ecosystem of vendors and internal tools. We aren't looking for someone to follow a manual; we need a high-velocity operator who can design the roadmap, optimize, and leverage modern technology to scale our impact as we grow.

Your Responsibilities and Impact:

Operational Oversight & Performance

  • Lead Enterprise Execution: Optimize payment integrity initiatives across internal, vendor, and AI-enabled workflows, maintaining full accountability for prepay and postpay performance.

  • Master the Pipeline: Manage the health of audit queues by ensuring work inflow and outflow are accurately forecasted, balanced, and executed against SLA targets.

  • Drive Results: Monitor program KPIs—including savings, throughput, and audit yield—taking corrective action and optimizing vendor/AI-supported execution to meet goals.

  • Strategic Translation: Convert organizational strategy into actionable operational plans that align with savings targets, audit integrity, and regulatory compliance.

Scalability & Innovation

  • Architect Scalable Solutions: Bridge high-level strategic design with hands-on execution to build repeatable workflows and robust process controls that sustain performance during rapid growth.

  • Modernize Workflows: Integrate LLM-driven automation and AI capabilities into operational workflows to streamline manual hand-offs and maximize cost efficiency.

  • Continuous Improvement: Use data to identify root causes of inefficiencies across workflows and systems, leading the development of solutions to reduce future operational risk.

Required Skills and Experience:

  • Bachelor’s degree and 6+ years of professional experience in high-growth operations, strategy, or healthcare management.

  • Experience working with data-driven or AI-enabled workflows (no coding required) to drive operational impact.

  • Proven ability to drive results across Operations, Product, and Engineering. You don't just follow a roadmap; you help build it.

  • A strong understanding of the US healthcare ecosystem and its financial "pipes," with the ability to navigate the claims lifecycle even if you aren't a niche billing expert.

  • The ability to manage and optimize complex, multi-layered processes across vendors, tools, and teams.

  • You are energized by the "messy middle"—you can build processes where none exist and pivot gracefully as the company needs a shift.

  • You are equally comfortable presenting high-level strategy to senior leadership as you are rolling up your sleeves to execute tactical daily work.

  • Ability to use the company’s vision and values as a North Star when making difficult operational trade-offs.

Desired skills and experience:

  • Proficiency with SQL

  • Familiarity with agile methodologies or frameworks for managing complex, cross-functional initiatives

#LI-Remote
Salary range: $104,500 - $155,000 /year

The pay range listed for this position is the range the organization reasonably and in good faith expects to pay for this position at the time of the posting. Once the interview process begins, your talent partner will provide additional information on the compensation for the role, along with additional information on our total rewards package. The actual base salary offered will depend on a variety of factors, including the qualifications of the individual applicant for the position, years of relevant experience, specific and unique skills, level of education attained, certifications or other professional licenses held, and the location in which the applicant lives and/or from which they will be performing the job.

Our Total Rewards package includes:

  • 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....

*Our total rewards package is for full time employees only. Intern and Contract positions are not eligible.

Healthcare equality is at the center of Devoted’s mission to treat our members like family.  We are committed to a diverse and vibrant workforce. 

At Devoted Health, we’re on a mission to dramatically improve the health and well-being of older Americans by caring for every person like family. That’s why we’re gathering smart, diverse, and big-hearted people to create a new kind of all-in-one healthcare company — one that combines compassion, health insurance, clinical care, service, and technology - to deliver a complete and integrated healthcare solution that delivers high quality care that everyone would want for someone they love. Founded in 2017, we've grown fast and now serve members across the United States.  And we've just started. So join us on this mission!

Devoted is an equal opportunity employer. We are committed to a safe and supportive work environment in which all employees have the opportunity to participate and contribute to the success of the business. We value diversity and collaboration. Individuals are respected for their skills, experience, and unique perspectives. This commitment is embodied in Devoted’s Code of Conduct, our company values and the way we do business.

As an Equal Opportunity Employer, the Company does not discriminate on the basis of race, color, religion, sex, pregnancy status, marital status, national origin, disability, age, sexual orientation, veteran status, genetic information, gender identity, gender expression, or any other factor prohibited by law. Our management team is dedicated to this policy with respect to recruitment, hiring, placement, promotion, transfer, training, compensation, benefits, employee activities and general treatment during employment.

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