Special Needs Plans Operations Manager

. Develop Devoted's Models of Care (MOCs) annually in collaboration with the SNP Operations Director .

Posted 9/25/2026full-timeRemote • United StatesMid-LevelSenior💰 $73,000 - $130,000 per yearWebsite

Key responsibilities & impact

Develop Devoted's Models of Care (MOCs) annually in collaboration with the SNP Operations Director
Oversee and manage Devoted's policies, procedures, and compliance universes in compliance with CMS and Model of Care requirements, ensuring perpetual audit-readiness
Review new or changing Model of Care and CMS requirements, working cross-functionally to develop and implement operational solutions
Develop and implement enhanced processes to oversee compliance with Model of Care and CMS-related SNP requirements, including building early warning systems to detect and prevent potential gaps
Develop Medicaid benefit subject matter expertise, creating knowledge tools and configurations that support frontline staff and members in understanding and coordinating Medicare and Medicaid benefits
Oversee routine Medicaid reporting with the SNP Operations Director and other SNP Managers, and work cross-functionally to develop and submit required Medicaid reports accurately and timely
Provide additional compliance and operational support across SNP and Medicaid programs as assigned

What you’ll need

3+ years of experience in Medicare Advantage, Managed Care, Health Plan, or health care operations
Proven ability to interpret CMS and/or State Medicaid regulatory guidelines and translate them into standard operational workflows and compliance processes
Highly detail-oriented, reliable, independent, and curious, with a track record of managing detailed compliance tasks in a fast-paced environment
Strong communication skills with a demonstrated ability to collaborate with and influence cross-functional teams
Direct experience with Special Needs Plans (SNPs), SNP Model of Care (MOC) development and implementation, or SNP care management operations preferred
Experience in the Medicaid space, such as Medicaid compliance, benefits administration, claims processing, or D-SNP dual-eligible benefit coordination preferred

Comp & perks