Job Description
A bit about this role:
At Devoted, we know that one of the most important ways we will build trust with our network of providers and members is to pay claims accurately and on time while having transparent payment policies. 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.
The Senior Manager, Payment Integrity is a senior operational leader responsible for overseeing the strategy, execution, and performance optimization of the organization's payment integrity programs. This role ensures that both prepayment and post payment audit functions are designed and delivered to achieve savings, reduce error rates, and align with regulatory requirements. The Senior Manager drives operational excellence, manages escalations, collaborates cross-functionally to improve end-to-end audit workflows, and provides guidance to internal teams and external partners.
Your Responsibilities and Impact will include:
Lead and optimize the execution of enterprise payment integrity initiatives, with accountability for performance across prepay and postpay claims review programs.
Translate organizational strategy into operational action plans, ensuring alignment with savings goals, audit integrity, and regulatory compliance.
Partner with analytics, finance, compliance, and tech to identify new audit opportunities, improve processes, and develop scalable solutions.
Oversee the health of audit pipelines by ensuring work inflow and outflow are properly forecasted, balanced, and executed.
Monitor program KPIs such as savings, throughput, adjustment timeliness, and audit yield. Take corrective action when performance falls short.
Use data to identify root causes of inefficiencies or payment errors and lead the development of solutions to reduce future risk.
Serve as a senior escalation point for complex issues involving claims adjustments, provider disputes, and operational bottlenecks.
Collaborate with departments such as Claims, Appeals, Provider Relations, and Medical Management to troubleshoot issues and implement improvements across the payment life cycle.
Required skills and experience:
Bachelor’s degree and 6+ years of professional experience in high-growth operations, strategy, or healthcare management
Proven ability to drive alignment across departments (Operations, Product, Engineering) and manage up to senior leadership. You don't just follow a roadmap; you help build it
An understanding of the US healthcare ecosystem. You understand how the "pipes" work, even if you aren't an expert in every niche billing code
You are energized by ambiguity. You can build a process where one doesn't exist and pivot gracefully when company needs shift
You are equally comfortable presenting a high-level strategy as you are rolling up your sleeves to execute the tactical daily work
Ability to use the company’s vision and values as a North Star when making difficult operational trade-offs
Desired skills and experience:
Proficiency with SQL
Familiarity with agile methodologies or frameworks for managing complex, cross-functional initiatives
#LI-Remote
Salary range: $104,500 - $155,000 /year
The pay range listed for this position is the range the organization reasonably and in good faith expects to pay for this position at the time of the posting. Once the interview process begins, your talent partner will provide additional information on the compensation for the role, along with additional information on our total rewards package. The actual base salary offered will depend on a variety of factors, including the qualifications of the individual applicant for the position, years of relevant experience, specific and unique skills, level of education attained, certifications or other professional licenses held, and the location in which the applicant lives and/or from which they will be performing the job.
Our Total Rewards package includes:
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....
*Our total rewards package is for full time employees only. Intern and Contract positions are not eligible.
Healthcare equality is at the center of Devoted’s mission to treat our members like family. We are committed to a diverse and vibrant workforce.
At Devoted Health, we’re on a mission to dramatically improve the health and well-being of older Americans by caring for every person like family. That’s why we’re gathering smart, diverse, and big-hearted people to create a new kind of all-in-one healthcare company — one that combines compassion, health insurance, clinical care, service, and technology-to deliver a complete and integrated healthcare solution that delivers high quality care that everyone would want for someone they love. Founded in 2017, we've grown fast and now serve members across the United States. And we've just started. So join us on this mission!
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.
devoted