Sr. Manager of Claims

Waltham, MA
Operations
Full-Time
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 and the Claims Program Manager will have the opportunity to help in the early stage development by bringing broad and deep expertise of Medicare claims programs and processes. The successful candidate will be one of a few Medicare claims experts at Devoted and will be comfortable making decisions in that role. This role is a combination of day to day processing of complex claims and strategic focus of building and improving the operation.  

Responsibilities will include:

    • Manage a team of local and offshore teams working collaboratively to achieve goals
    • Develop staffing and financial models to support the operation
    • Develop and execute end-to-end processes related to claims operations, such as processing complex claims (e.g. high dollar/COB/FWA)
    • Responsible for contributing and the execution of achieving the team’s vision, metrics, and operations
    • Identify and implement creative process improvement (must be excited to roll up your sleeves and make things better!)Develop expertise in all areas of Devoted Health’s claims operation
    • Understand and adhere to complex regulations and developing policies and procedures

Attributes to success:

    • A true operator who will roll up your sleeves and do whatever it takes to get the job done
    • You have a bias towards action and execution, and a track record to support your ability to get things done
    • Clear head for process
    • You are passionate about process improvement and efficiency, and have an ability to predict and prevent bottlenecks
    • You have stamina for tackling hard problems
    • Experience working with complex data and implementing systems and workflows
    • A creative thinker with a can-do attitude - we are building systems from the ground up and want fresh ideas
    • Strong communicator who can work with cross-functional stakeholders and drive alignment

Desired skills and experience:

    • 5+ years in Medicare claims operations or consulting
    • Healthcare experience at a payer working on; contract configuration, benefit configuration, SIU/FWA a plus
    • CPC also a plus
    • Track record of success developing and implementing systems and processes and setting and achieving ambitious targets


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.