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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! 
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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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.