Devoted Health

Operations

• Own provider data accuracy end to end across roster intake, credentialing, validation, verification, exception handling, remediation, and downstream directory publication
• Serve as accountable owner for provider directory compliance, including CMS Medicare Advantage accuracy and verification requirements and online directory obligations
• Maintain audit-ready documentation and lead responses to regulatory inquiries and audits
• Lead, manage, and grow a hybrid onshore and offshore team through hiring, onboarding, training, quality assurance, capacity planning, and performance management
• Operate and improve signal-driven accuracy infrastructure using scoring and prioritized verification queues
• Define, instrument, and report provider data accuracy metrics and SLAs to executive stakeholders
• Translate results into a prioritized roadmap
• Shape directory strategy with product, engineering, and network leaders to support care navigation
• Ensure accurate and complete data for specialty, panel status, accepting-new-patient indicators, location, and PCP assignment
• Partner with product and engineering to automate manual validation work
• Evaluate and manage vendors supporting provider data and directory accuracy

Senior Manager, Provider Operations

General

• Build and maintain relationships with community gatekeepers and influencers to secure high-traffic venues for agent prospecting
• Source, plan, and host sales and marketing events focused primarily on lead generation
• Deliver Medicare educational presentations
• Collaborate with Broker Managers to align outreach strategies and coordinate agent assignments for events
• Train and motivate external agents on community-based marketing, event etiquette, and lead-generation techniques
• Partner with local provider groups on strategic co-op marketing initiatives
• Ensure activities adhere to Medicare marketing guidelines and CMS compliance regulations
• Track local ROI and refine market strategy

Community Outreach Specialist

Associate

• Support the administrative needs of new and existing Devoted Medical programs through process design and process escalation
• Maintain positive relationships with provider groups and providers
• Maintain the back-office infrastructure, including electronic health record, fax line, and visit scheduling systems
• Support procurement of clinical and non-clinical materials
• Maintain Devoted Medical clinical staff calendars for availability
• Onboard and offboard Devoted Medical employees
• Assist with maintaining clinician files
• Communicate frequently with team members and leadership and ensure follow-up tasks are completed timely

Practice Associate

Pharmacist

• Serve as the primary subject matter expert for medication-related aspects of the EHR build across clinical workflow design, regulatory compliance, and adoption of best practices
• Maintain Devoted Medical's e-prescribing functionality and technical partnerships/integrations with Surescripts and Medi-Span
• Manage internal medication information mapping tools in Devoted’s platform
• Conduct rigorous clinical testing to validate medication-related processes within the EHR
• Manage certifications and systems integration testing in partnership with engineering teams and LLM agents
• Bridge clinical practice, engineering, and integrations to support medication documentation, prescribing, and monitoring

Manager, Pharmacy Informatics

Advanced Practice Provider

• Conduct primarily telehealth video visits, with limited and occasional in-home visits to members in your local area
• Perform comprehensive assessments and provide evidence-based care focused on prevention, chronic condition support, medication optimization, and health maintenance
• Identify and address care gaps, coordinate with external and internal care team members, and contribute to individualized, whole-person care plans
• Utilize integrated technology and AI-enabled workflows to reduce administrative burden and maximize meaningful member interaction time
• Communicate with empathy and clarity, fostering trust and confidence with members and caregivers
• Collaborate closely with primary care providers, specialists, pharmacists, nurses, care coordinators, caregivers, and families to deliver coordinated, member-centered care

Telehealth Preventative Primary Care Advanced Practice Provider – NP/PA

• Deliver virtual telehealth acute care to members with emergent or critical illness
• Evaluate and diagnose acute illnesses
• Order and interpret diagnostic tests
• Establish care plans and prescribe appropriate medications
• Assess quality-of-care interventions, social needs, home health needs, and DME needs
• Coordinate care with PCPs, specialists, pharmacy, clinical nursing, social work, family members, and caregivers
• Use Devoted's electronic health information system for visits and provide feedback to improve the interface
• Provide weekend on-call support to clinical nurses in certain geographies
• Support new clinical and organizational programs and initiatives
• Integrate innovative virtual care practices
• Collaborate with physicians, APPs, medical assistants, documentation experts, practice administrators, social workers, and clinical nurse partners

Advanced Practice Provider, NP/PA

Product Manager

• Develop and own the product roadmap for the assigned area
• Drive measurable operational outcomes including cost reduction, clinical quality, member experience and retention, and team efficiency
• Partner with Engineering, Data Analytics, Operations, Clinical, and Compliance teams to define and execute product initiatives
• Communicate insights, progress, and outcomes to senior stakeholders
• Translate complex data and product strategy into clear, actionable information
• Act as the subject matter expert for the product area and digital service delivery
• Provide insights and guidance to senior leadership

Product Leader

QA Engineer

• Serve as an expert on ICD-10-CM coding guidelines, AHA Coding Clinic guidance, and internal risk adjustment guidance
• Oversee an offshore FDR vendor team of QA Reviewers, including accuracy and productivity standards, performance review, and volume allocation
• Escalate staffing, training, and quality gaps to vendor management
• Own and maintain QA policies and SOPs for coding quality, retrospective coding, and audit operations
• Plan QA review coverage and representative sampling across internal staff and vendors
• Perform QA reviews of escalated, disputed, and high-risk charts and resolve coding disagreements
• Own monthly and quarterly QA Scorecard processes and remediation follow-through
• Identify documentation and coding trends and convert findings into education, job aids, or process changes
• Measure QA team accuracy and incorporate findings into the QA process
• Partner with vendor leadership on quality expectations, corrective action, and escalation
• Resolve coding questions and maintain the questions-and-answers log
• Partner with technology and analytics teams on risk adjustment tooling, including AI-assisted coding
• Define QA requirements, test releases and enhancements, and provide feedback on technology design and performance
• Build and run production monitoring for tools, tracking performance drift and error patterns
• Support retrospective coding and audits by abstracting medical records or ICD-10 codes for CMS submission
• Recommend process improvements and prepare department reporting
• Serve as a voting risk adjustment coding SME on Devoted’s Coding Steering Workgroup
• Handle patient data ethically under HIPAA Privacy and Security rules
• Perform other related duties as required

Quality Assurance Manager

Medical writer

• Report to the Manager, Clinical Documentation Improvement as part of the Practice Operations team
• Perform medical record audits based on organizational priorities, including concurrent CDI workflows and retrospective auditing
• Conduct coding validation reviews that may lead to adding, deleting, adjusting, or confirming diagnoses
• Initiate provider queries for documentation clarification
• Utilize and review AI tools and Human-in-the-Loop outputs
• Assist in creating and communicating provider and vendor education about compliant coding trends and opportunities
• Collaborate with the CDI Manager to improve coding quality goals and outcomes
• Remain current on ICD-10-CM coding guidelines, AHA Coding Clinic Guidance, and CMS Risk Adjustment guidance
• Ensure diagnostic information, coding, and claims submitted on behalf of Devoted Medical are accurate, complete, and compliant

Clinical Documentation Integrity – Claims Auditor

Manager

• Manage day-to-day administration of medical, dental, vision, life, retirement, and voluntary benefits
• Act as team support/backup for the Leave Specialist
• Serve as the primary point of contact for employee benefits inquiries, qualifying life events, and dependent eligibility verifications
• Partner with HRIS and payroll teams to ensure accurate premium deductions, carrier feeds, and data integrity
• Translate complex benefit plan designs, policy changes, and coverage details into clear, engaging communications
• Champion new hire benefits onboarding collateral and lead weekly New Hire Benefit presentations
• Monitor new hire questions to improve employee understanding and appreciation of their benefits package
• Drive continuous process improvement using technology and AI tools
• Oversee annual Open Enrollment logistics, system configurations, testing, vendor coordination, communications, toolkits, and informational sessions
• Perform other duties as assigned

Employee Benefits Manager

Care Coordinator

• Lead real-time digital member support through Portal Chat, delivering accurate, empathetic guidance and resolving member needs efficiently
• Manage multiple concurrent conversations while maintaining strong response times and meeting digital service level expectations
• Use internal tools, knowledge base, and AI-assisted resources to research member questions and provide reliable information
• Identify issues requiring escalation and create cases or handoffs to partner teams for timely follow-up and resolution
• Collaborate with peers, clinical partners, and cross-functional teams to resolve member needs end-to-end
• Participate in quality reviews, coaching sessions, and ongoing training
• Share insights to improve workflows, guidance, and the digital member experience
• Adapt to evolving digital tools, workflows, and operational priorities as the Digital Guide program scales

Digital Care Coordinator

• Own oversight of daily operations and long-term strategy for Document Services
• Monitor and develop the Inbound Correspondence and Outbound Print Production programs
• Serve as the connective point between Document Services and cross-functional partners
• Manage vendor relationships and the department budget on behalf of the Director and VP of Membership Operations
• Ensure compliance across every document entering or leaving the organization
• Own the operating model for Inbound Correspondence and Print Production, including intake, routing, turnaround standards, operational monitoring, and escalation paths
• Build capacity and forecasting plans anticipating membership growth and seasonal volume
• Build repeatable tooling such as playbooks, intake processes, readiness trackers, adoption dashboards, and KPIs
• Leverage AI technology and reporting tooling to analyze trends and drive change
• Build monitoring and communication plans for visibility into risk, delay, and volume shifts
• Represent Document Services in Product and Technology roadmaps and design decisions
• Act as primary point of contact for Compliance, IT, Marketing, MXE, Guide, DMG, and Product/Technology teams
• Build partnerships across operations stakeholders and design solutions for the whole organization
• Partner with Compliance to maintain audit-ready documentation and represent Document Services in internal and external audits
• Ensure programs meet regulatory and contractual requirements, including notice timeliness, accessibility, and record retention
• Oversee inbound mail and fax vendors and outbound fulfillment vendors
• Define performance standards, scorecards, business reviews, issue resolution processes, vendor budgeting, and forecasting

Senior Manager, Document Services

• Supports clinical outreach campaigns by making outbound calls and utilizing portal chat to members to schedule appointments with the pharmacist team to address clinical gaps or medication concerns
• Supports cost of care efforts by reaching out to providers and members to offer lower cost alternative medication options
• Manages an assigned caseload which may require provider, pharmacy, and/or member follow-up to address medication recommendations, concerns, or questions
• Independently oversees assigned cases and outreaches with timely follow-up, clear next steps, and thorough documentation
• Helps members navigate their Devoted Health benefits
• Participates in sprints, pilots, and special projects as they launch
• Collaborates with the broader pharmacy team to support shared goals and coverage needs
• Assists with training and shadowing when new team members join the team
• Participates in team and pharmacy department activities and responsibilities

Pharmacy Care Coordinator – Clinical Pharmacy Operations

• Research escalated and complex retroactive transaction work using CMS guidance, established procedures, and professional judgment
• Build repeatable, self-serve operational tooling, including playbooks, intake, readiness trackers, and adoption dashboards
• Prepare and submit transactions through MARx, the MAPD Help Desk, and eRPT for applicable effective dates
• Monitor case aging against category boundaries and prioritize work based on risk
• Track and report category mix, detection latency, aging, and slippage; escalate capacity constraints
• Coordinate downstream remediation including claims re-adjudication, pharmacy support, premium adjustments and refunds, subsidy and penalty corrections, prescription drug event corrections, materials and ID card reissuance, and member and provider notification
• Serve as a knowledgeable point of contact for escalated member situations involving retroactive corrections
• Analyze business impacts, requirements, and recommended actions under applicable federal and state laws, regulations, CMS policy guidance, and contract standards
• Monitor non-compliant trends and root causes and collaborate with Enrollment, Sales Compliance, Agent oversight, Product, and Engineering to correct upstream gaps
• Maintain complete, reconstructable records of retroactive cases for audit, data validation, and annual readiness
• Represent the Membership Operations team when relating with diverse groups of people

Senior Membership Operations Associate – Retroactivity

• Conduct primarily telehealth video visits, with limited and occasional in-home visits to members in the local area
• Perform comprehensive assessments and provide evidence-based care focused on prevention, chronic condition support, medication optimization, and health maintenance
• Identify and address care gaps
• Coordinate with external and internal care team members
• Contribute to individualized, whole-person care plans
• Utilize integrated technology and AI-enabled workflows to reduce administrative burden and maximize meaningful member interaction time
• Communicate with empathy and clarity, fostering trust and confidence with members and caregivers
• Collaborate with primary care providers, specialists, pharmacists, nurses, care coordinators, caregivers, and families to deliver coordinated, member-centered care