Jobs at Devoted Health

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.

Lead data science across Growth and Membership Operations: define problems, build scalable data models and pipelines, develop analytical and ML solutions, partner cross-functionally, and integrate AI tools to optimize sales, marketing, telesales, and enrollment operations.

The Business Applications Manager will oversee the financial tech stack, focusing on NetSuite administration, internal controls, and process improvements while managing projects and cross-functional communication.

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.

Lead design and delivery of enterprise capabilities within Devoted's Orinoco platform. Build integrations, APIs, and automations to streamline operations, ensure compliance, enable data access, and reduce operating costs while partnering with HR, Finance, Security, and Tech teams.

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.

Perform detailed QA and editing of member-facing and internal content across channels (SMS, email, portal, letters, knowledge base). Simplify complex healthcare content into plain language, maintain consistency and compliance, write and revise copy, interact with AI agents to streamline workflows, meet high-volume deadlines, and collaborate with content strategists. Portfolio required.

Lead and perform end-to-end technology audits across cloud, cybersecurity, and AI environments. Design audit methodology and tooling, apply data analytics and AI to testing, assess AI governance and IT controls, manage stakeholder relationships, ensure IIA Standards compliance, and coach junior auditors while delivering findings to senior leadership.

Lead finance operations for provider risk-sharing and reinsurance arrangements: own settlement, accounting, forecasting, reserves and reporting; partner cross-functionally (actuarial, claims, network, data, engineering, legal) to design controls, policies, reconciliation, dispute resolution, and regulatory/audit responses; support provider relationships and analytic tooling to monitor performance and payments.

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

Perform prospective, concurrent, and retrospective utilization reviews for inpatient, behavioral health, and post-acute services against CMS and Medicare Advantage criteria; assess medical necessity and level of care; prepare cases for Medical Director review and coordinate peer-to-peer discussions; document determinations, ensure regulatory compliance, and monitor resource stewardship to optimize member care and appropriate utilization.

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.

Manage end-to-end paid digital marketing campaigns across Meta, YouTube, Search, and other channels. Coordinate vendors, collaborate with creative and compliance teams, ensure error-free materials, track performance in Looker and Google Sheets, and use project management tools to keep multiple campaigns organized and optimized.