Jobs at Devoted Health

Identify, engage, and contract healthcare providers to build and maintain a Medicare Advantage network within a geographic region. Manage outreach, negotiate and execute standard agreements, track documentation and workflows, collaborate with Legal, Credentialing, Finance and Market teams, use data to support negotiations, and drive process improvements to meet network adequacy and growth goals.

Lead end-to-end provider data and directory accuracy, ensuring compliance with CMS Medicare Advantage requirements. Manage and scale a hybrid onshore/offshore team, implement signal-driven verification workflows, define SLAs and reporting, partner with product and engineering to automate validation, and support care navigation initiatives through accurate provider metadata and vendor management.

Lead and execute end-to-end provider network contracting across Commercial and Medicare Advantage lines. Close complex negotiations with physician groups and ancillary providers, optimize fee schedules and pricing, and operationalize agreements with Provider Ops, Claims, and Credentialing. Build and mentor a high-performing contracting team, standardize playbooks, and leverage AI-assisted tools and data visualization to accelerate deal execution and reporting. Collaborate cross-functionally with Actuarial, Underwriting, Product, and Sales to support market expansion and competitive pricing.

Lead cross-functional initiatives for agency onboarding, compliance analysis, and partnership enhancements. Scope, plan, and drive projects to implementation using JIRA and Looker, design scalable processes, manage risks and reporting, and support relationship management for top agency partners while ensuring compliance and operational efficiency.

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.

The Senior Manager, AI Performance & Operations is responsible for the performance and improvement of AI workflows, incident response, designing evaluation systems, and stakeholder communication.

Provide telephonic and virtual social work case management for high‑needs patients: assess social determinants, develop personalized care plans, coordinate community and clinical resources, support caregivers, facilitate advanced care and palliative/hospice planning, and collaborate with an interdisciplinary team to improve outcomes.