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Devoted Health logo
Devoted Health

Our mission: to dramatically improve the health & well-being of older Americans by caring for everyone like family

Payment Integrity Operations Senior Manager

OperationsOperationsFull TimeRemoteLeadTeam 1,001-5,000Since 2017H1B No SponsorCompany SiteLinkedIn

Location

United States

Posted

8 days ago

Salary

$105K - $155K / year

Seniority

Lead

No structured requirement data.

Job Description

Payment Integrity Operations Senior Manager

Devoted Health

Role Description 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 part of this function, the Payment Integrity Operations Senior Manager is responsible for ensuring the success of Payment Integrity (PI)’s internal programs and processes. The ideal candidate is a self-starter who enjoys taking accountability for operational performance, solving complex operational problems and driving impact in close collaboration with cross-functional stakeholders and teams. Your Responsibilities and Impact will include: - Operational Orchestration: Own the daily health of the operation—monitoring TAT (Turnaround Time), clearing backlogs, and ensuring queue health remains optimal. - Hybrid Workforce Management: Manage and unblock a diverse workforce, including offshore staff augmentation, internal audit teams, and AI agents. - Capacity & Staffing Strategy: Own the staffing model and capacity planning to ensure we are scaled correctly for volume fluctuations. - Friction Removal: Act as the primary escalation point to resolve blockers for vendors and internal teams, ensuring they have the training and job aids needed to succeed. - Efficiency & AI Integration: Identify opportunities to lean out manual processes by deploying and managing AI agents alongside human staff. - SLA & Quality Governance: Oversee vendor performance and maintain the feedback loop between high productivity and rigorous audit accuracy. Qualifications - Thrives in operational execution, escalation management, and problem-solving. - Comfort with ambiguity, including unanticipated and sometimes messy issues that require ownership from triage to resolution. - Analytic mindset and ability to execute qualitative and quantitative analyses that drive impact. - Results-oriented, with a willingness to take initiative and get into details to get the job done. - Exceptional communication and cross-functional collaboration skills, with an ability to influence others. - Strong organizational skills, including prioritizing and managing multiple initiatives at once. - High degree of professionalism. - Desire and ability to quickly learn new domain (Payment Integrity) and skills, including use of LLM to optimize operations. Requirements - 6+ years of operations experience (Medicare Advantage health plan and/or startup a plus). - Experience deploying AI/LLM technologies to solve business challenges. - Experience influencing and driving change in a highly-matrixed organization. Benefits - 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...

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