Director of Claims and Provider Services

: 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! A bit about this role: This role is key in our organization. At Devoted Health we have the resources, appetite and capabilities to reimagine operations as it should be, not how the industry at large has built it and this role will lead that charge. The Director of Claims and Provider Services is an experienced, results-driven leader who will oversee our organization's operation. The ideal candidate will have a deep understanding of the Managed Care reimbursement cycle, a proven track record of improving efficiency, quality, provider satisfaction, and the ability to drive strategic initiatives. As the Director of Claims and Provider Services, you will play a critical role in ensuring the accuracy, compliance, and efficiency of our reimbursement and servicing processes. Your Responsibilities and Impact will include:

• Implement strategies to streamline operations, reduce processing times, improve quality, satisfaction and enhance overall effectiveness
• Ensure compliance with regulatory requirements, industry standards, and internal policies
• Own and improve key performance indicators (KPIs) for performance of internal and offshore operations
• Work closely with internal departments, including but not limited to; finance, IT, clinical services, network management, compliance and appeals/grievance to ensure seamless collaboration and information flow
• Collaborate with stakeholders to address issues and improvements
• Lead and mentor the teams, fostering a culture of accountability and continuous improvement

Required skills and experience:

• Bachelor's degree in Health Administration, Business, or equivalent combination of experience and education
• Extensive experience (8+ years) in operations, with a focus on leadership and strategy
• Strong analytical and problem-solving skills, with proficiency in data analytics tools
• Strong communication and facilitation skills with all levels of the organization, including the ability to resolve complex issues and build consensus among diverse groups
• Proven leadership competencies in designing, developing and implementing process structure, tools and measurement indicators that drive operational results

Desired skills and experience:

• Ability to lead and motivate teams through change and process improvement
• In-depth knowledge of managed care reimbursement process, regulations, and compliance requirements
• Proven experience in effectively managing offshore service provider performance and delivery quality

#LI-DS1 #LI-Remote Salary Range: $155.000-$230,000 / year Our ranges are purposefully broad to allow for growth within the role over time. 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 may 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. 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.