Jobs at Devoted Health

Provide technical support for employees across ChromeOS and MacOS; administer and maintain core SaaS tools (Google Workspace, Jamf, Slack, Atlassian); maintain in-office AV, networking, and peripherals; triage and resolve helpdesk tickets, improve IT processes, document knowledge base articles, and collaborate with cross-functional teams to keep the digital workplace secure and user-friendly.

Lead product strategy and roadmap execution for healthcare initiatives, driving measurable outcomes in cost reduction, clinical quality, service experience, retention, and team efficiency. Partner with Clinical, Operations, Data Analytics, Engineering, and Compliance teams; communicate product insights to senior stakeholders; and serve as the subject matter expert for digital service delivery. The role requires strong software product management experience, healthcare expertise, data-driven decision-making, and the ability to ship consumer, practitioner, and AI-enabled products.

Audits medical records and claims to validate diagnoses, coding accuracy, completeness, and compliance with ICD-10-CM, CMS, and organizational guidelines. Performs concurrent and retrospective CDI reviews, submits provider queries, evaluates AI-assisted auditing outputs, educates providers and vendors, identifies coding trends, and recommends process improvements. Requires relevant coding or CDI certification and substantial outpatient CDI or risk adjustment auditing experience.

Owns the quality assurance program for retrospective coding and auditing operations, including policies, sampling, reviewer oversight, vendor management, escalated chart reviews, scorecards, remediation, and coding education. The role requires expertise in ICD-10-CM, risk adjustment, medical record abstraction, and compliance. It also partners with technology and analytics teams to validate AI-assisted coding tools, monitor production performance, and improve coding accuracy across internal and offshore teams.

Manage day-to-day administration of employee health, welfare, retirement, and wellness benefits. Support employee inquiries, qualifying life events, eligibility verification, HRIS and payroll integrations, benefit communications, onboarding, open enrollment, system testing, vendor coordination, and process improvement. The role requires translating complex benefits information into accessible communications and presentations while partnering with HR, payroll, HRIS, consultants, and vendors.

Leads daily operations and long-term strategy for inbound correspondence and outbound print production. Oversees operating models, capacity planning, reporting, tooling, compliance, audits, vendor performance, budgets, and cross-functional partnerships across health plan functions. Builds scalable workflows, dashboards, scorecards, and monitoring processes while ensuring regulatory requirements, document accuracy, timeliness, accessibility, and retention standards are met.

Research and resolve complex retroactive Medicare enrollment and payment corrections using CMS guidance and applicable regulations. Submit MARx, MAPD Help Desk, and eRPT transactions; monitor aging, risks, trends, and capacity; coordinate claims, pharmacy, billing, subsidy, notification, and ID-card remediation. Build repeatable operational tooling, maintain audit-ready case records, analyze root causes, and collaborate with Enrollment, Compliance, Product, Engineering, and other stakeholders.

Manages pharmacy fraud, waste, and abuse investigations and the CVS PBM relationship. Validates and reconciles pharmacy claims, provider, eligibility, prior authorization, and external data to identify discrepancies and fraud indicators. Uses AI/ML detection tools, develops investigative referrals, reviews vendor performance and reporting, maintains audit-ready case records, and presents findings to leadership, legal, regulators, or law enforcement. Partners with compliance, claims, pharmacy, clinical, and data teams while mentoring junior analysts and improving SIU processes.

Leads cost accounting policies, allocation methodologies, profitability analysis, financial modeling, budgeting, forecasting, month-end close, variance analysis, and management reporting. Builds business cases and ROI analyses, supports intercompany accounting and compliance inquiries, and improves financial processes through scalable technology and self-service reporting. Partners with operational teams to improve cost performance and standardize controls.

Prepare monthly, quarterly, and annual statutory financial statements and supplemental filings for NAIC and state regulators. Support insurance audits, reconciliations, filing submissions, reporting-system testing, and reinsurance accounting initiatives. Review filings, lead ad hoc finance projects, improve processes, maintain documentation, and meet strict reporting deadlines in a fast-paced environment.

The Senior Treasury Manager leads cash management, liquidity forecasting, international and multi-currency banking, debt and covenant compliance, capital flows, investments, treasury controls, audits, and policy administration. The role owns Kyriba, manages banking and payments relationships, supports regulated and commercial entities, and partners across Finance, Legal, Tax, Accounting, Compliance, and clinical organizations. Initially an individual contributor, this position may develop and manage a team as the treasury function expands.

Owns end-to-end CMS healthcare data and medical record submissions, including file preparation, validation, quality assurance, portal uploads, issue triage, tracking, and compliance documentation. Coordinates submission work, partners with IT and technical teams to resolve system issues, manages secure file transfers, reports metrics and error trends, and maintains standard operating procedures. Supports CMS RADV and Part C improper payment audits while ensuring accurate, timely, and compliant submissions.

Own pharmacy benefits strategy for a commercial book of business, including PBM relationships, contracting, audits, trend analytics, savings initiatives, formulary and utilization management, specialty-drug strategy, and implementations. Lead cross-functional coordination with Finance, Legal, Clinical, Data, vendors, and clients. Oversee ERISA fiduciary processes, CAA/RxDC transparency compliance, member experience, forecasting, and reconciliation of projected versus realized savings.

Lead Devoted Health’s multi-year interoperability strategy, regulatory compliance, data exchange operations, telephony, vendor partnerships, and external relationships. Build and scale cross-functional teams spanning clinical, operations, engineering, data, legal, and compliance. Drive FHIR/API-based initiatives, health information exchange, and EHR, clinical, claims, and pharmacy integrations while translating complex standards and regulations into executive decisions and measurable improvements in care quality, operational efficiency, and data reliability.

Lead end-to-end operational and financial audits, including risk assessment, planning, testing, documentation, issue development, and reporting. Review audit workpapers, coach internal and co-sourced auditors, support QAIP readiness, contribute to the annual audit plan, and build stakeholder relationships. Apply data analytics, AI, and agile techniques to improve audit quality and efficiency while ensuring compliance with IIA standards and internal methodology.

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 clinical pharmacy strategy and execution for Medicare Advantage and Part D Stars measures. Own performance forecasting, measure readiness, regulatory interpretation, cross-functional vendor collaboration (including PBM), and implementation of interventions to drive 5-Star outcomes. Build trackers, set OKRs, audit outreach effectiveness, and represent pharmacy quality in executive forums.