Claims Compliance Program Manager

Devoted Health

. Monitor claims compliance activities, KPIs, and reports to identify trends, risks, operational gaps, and areas for improvement .

Posted 10/26/2026full-timeRemote • United StatesMid-LevelSenior💰 $73,000 - $130,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in compliance monitoring, data analysis, and operational reporting within healthcare operations. Proficient in developing policies and procedures while effectively collaborating across teams to enhance compliance and mitigate risks.

Highest-signal resume keywords

Claims Compliance MonitoringData AnalysisRegulatory AuditsStandard Operating Procedures DevelopmentInterpersonal Communication

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Compliance ReportingOperational ReportingData ValidationRisk AssessmentWorkflow EvaluationCorrective Action PlansIssue ResolutionAudit DocumentationKPI TrackingClaims Adjudication

Soft Skills

CollaborationVerbal CommunicationPrioritizationAutonomyInterpersonal Skills

Tools & Technologies

JiraData Reporting Platforms

Industry Keywords

Healthcare OperationsRegulatory ComplianceHealthcare TechnologyOperational MonitoringAudit Workflows

About the role

Key responsibilities & impact

Monitor claims compliance activities, KPIs, and reports to identify trends, risks, operational gaps, and areas for improvement
Coordinate and document internal, financial, and regulatory audits
Analyze claims data to identify discrepancies and recurring issues
Track compliance issues, deliverables, Jira tasks, and audit findings, collaborating cross-functionally to ensure timely remediation
Support quality assurance operations, including audit workflows, operational reporting, and data validation
Develop and update policies, procedures, and related compliance materials
Escalate compliance concerns and control deficiencies to management
Participate in risk assessments to strengthen internal controls
Collaborate across Claims, Payment Integrity, and Compliance teams to investigate issues
Evaluate workflow gaps and recommend practical solutions to mitigate risks
Support the implementation and oversight of corrective action plans
Identify opportunities to improve the efficiency, accuracy, and consistency of assigned compliance activities
Assist with AI initiatives and automation projects in claims compliance operations

Requirements

What you’ll need

Proven ability to manage multiple priorities, support operational monitoring activities, and ensure timely tracking of compliance deliverables and issue resolution
Strong interpersonal and verbal communication skills to effectively collaborate across teams and engage with cross-functional stakeholders on audit and compliance findings
Proficient in drafting clear, precise, and structured compliance reports, summaries, and official audit documentation
Experience in developing, updating, and standardizing standard operating procedures (SOPs), policies, and workflow documentation
Bachelor's degree required, or equivalent work experience
Experience in healthcare, healthcare technology, or tech operations, preferred
Experience with healthcare operations, claims adjudication, or regulatory compliance requirements, preferred
Proven ability to thrive in a fast-paced startup environment
Capacity for high throughput, while working both autonomously and collaboratively with others
Track record of success becoming an expert with a tool or system that was unfamiliar to you
Comfort using data and reporting platforms to drive operational insights and track performance

Benefits

Comp & perks

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
Parental leave program
401K program