Plan Benefits Manager

| Waltham
A bit about us: 
We’re on a mission to change healthcare — how it’s paid for, delivered, experienced. We want to put people center stage, not process or profit. We are guided by a deep belief that every person on Medicare should be treated like we would treat a member of our own family: with loving care and a profound commitment to their health and well-being. 
That’s why we’re gathering a whole bunch of smart, big-hearted people to create a new kind of healthcare company — one that combines compassion, health insurance, clinical care, and technology seamlessly. 
We want to throw the long ball with people we love for a cause we believe in. Life is short. Join us.
A bit more about this role:
At Devoted, we know that one of the most important ways we will build trust is by ensuring we can pay claims accurately and on time, while providing the strategic flexibility to change payment models. Our Claims Operations team is responsible for managing claims processing and payment as well as contract and benefit configuration functions. Devoted is committed to building a team of people, effective processes and proprietary technology that delivers industry leading claims payment, accuracy and provider satisfaction. Devoted Health is building the core technology platform from the ground up. The Benefits configuration Specialist is responsible for configuring all aspects of Health Plan Benefit setup, analysis, mapping, testing, troubleshooting and implementation. The position is responsible for the daily operational activities which will ensure successful and accurate configuration of member cost share information. Position is a liaison to all departments regarding Benefit Interpretation issues.
We want to throw the long ball with people we love for a cause we believe in. Life is short. Join us.

Responsibilities will include:

  • Responsible for all aspects of Benefit configuration including interpretation, analysis, implementation and audit
  • Apply member cost share and benefit exclusion information from health plan evidence of coverage into the system
  • Develop test cases and documentation to support configuration changes/updates/additions, including annual/quarterly code loads
  • Assists in the research and resolution of Benefit inquiries submitted by other department within established time frames
  • Assist in completion of major projects. Define, develop, drive and deliver assigned small projects
  • Work with key project stakeholders to formulate and communicate business requirements and scope of project
  • Work with project stakeholders to translate their requirements into specifications technical staff can understand, translate questions that technical staff has into a format the stakeholders can understand and validate their requirements
  • Unit tests upon development to ensure requirements have been met
  • Identify potential areas of automation and aid in re-engineering the underlying business processes
  • Set up test environment and prioritize testing
  • Perform root cause analysis and issue resolution Execute and track test cases and documentation to support configuration changes/updates/additions and software implementations
  • Responsible for configuration, interface and application testing
  • Responsible for User Acceptance testing and implementation support
  • Develop and maintain standards for development of business processes and cases and their documentation
  • Coordinate multiple simultaneous projects and initiatives
  • Facilitates and leads meetings and selected work-groups

Attributes to success:

  • Curiosity and willingness to ask questions
  • A deep desire to improve and make a change in the healthcare experience
  • Preference towards collaboration and preventing silos
  • You roll up your sleeves and do whatever it takes to get the job done

Desired skills and experience:

  • 3-5 years experience in a benefit configuration role
  • CPC (Certified professional coder) or equivalent experience required
  • Spreadsheet and database skills required
  • Excellent written, verbal, and interpersonal communication skills required

If you love running towards complex challenges and transforming them into solutions, if you want to make a potentially huge impact on many lives, and if you are looking for a disruptive startup with an inspiring and talented team, Devoted Health may be the place for you! 

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Technology we use

  • Engineering
    • GolangLanguages
    • PythonLanguages
    • TypeScriptLanguages
    • ReactLibraries
    • recomposeLibraries
    • Apollo GraphQLLibraries
    • AngularJSFrameworks
    • gRPCFrameworks
    • AWSFrameworks
    • PostgreSQLDatabases
    • RedshiftDatabases

Location

Our sunny office is in the beautiful Watch Factory alongside the Charles River in Waltham. It's easily reachable by commuter train, bus, or bike.

What are Devoted Health Perks + Benefits

Devoted Health Benefits Overview

We offer bright, open office space with plenty of flexibility, awesome colleagues and a strong focus on our mission and supporting the work/life balance of all Devotees. We believe that taking care of ourselves will help us deliver the best possible service to our members.

We offer a free(100% employer paid) HMO Plan through Blue Cross Blue shield for our employees and their families. We also offer a PPO plan at a very limited cost.

Health Insurance & Wellness Benefits
Flexible Spending Account (FSA)
Dental Benefits
Fully company paid through Blue Cross Blue Shield
Vision Benefits
Fully company paid through Blue Cross Blue Shield
Health Insurance Benefits
We offer a free(100% employer paid) HMO Plan through Blue Cross Blue shield for our employees and their families. We also offer a PPO plan at a very limited cost.
Life Insurance
Offered through the Hartford
Wellness Programs
Wellness program where you can earn money back for healthy behavior along with an onsite gym and cross fit classes onsite
Onsite Gym
Yes, in our facility
Retirement & Stock Options Benefits
401(K)
Yes, we offer a 401K
Company Equity
Equity offered to all Devotees
Child Care & Parental Leave Benefits
Generous Parental Leave
We offer 3 months fully paid for maternity leave and 1 month paternity leave
Flexible Work Schedule
Family Medical Leave
Yes
Vacation & Time Off Benefits
Unlimited Vacation Policy
Generous PTO Polity
Generous PTO
Perks & Discounts
Casual Dress
We embrace the "bring your whole self to work" mantra and want folks to feel comfortable doing their best work
Company Outings
Company retreats, happy hours and team events
Stocked Kitchen
We offer healthy snacks including fresh fruit, bagels and cream cheese, popcorn, energy bars and dark chocolate.
Some Meals Provided
Free lunch weekly
Parking
Free parking onsite
Fitness Subsidies
BCBS reimburses up to 3 months of health club fees
Professional Development Benefits
Job Training & Conferences
We encourage and support our employees in continuing their educational endeavors.
Diversity Program
Devoted has a strong focus on building the most diverse and inclusive workforce we can. We won a 2018 NEVY award for diversity

Additional Perks + Benefits

The people at Devoted are drawn together with the common mission of making a material difference in the healthcare system as a whole and specifically in the lives of the members we serve. We are the type of company that supports employees as they move through the stages of their life while providing constant learning and opportunities for growth and change.

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