Job Description

A bit about this role:

The Provider Escalation & Education (Prov Esc/Edu) team is dedicated to maintaining strong operational relationships with our Critical Provider Organizations (CPOs) while focused on building partnerships that reduce frustration through efficient issue management and proactive solutions. Our mission is to minimize unnecessary friction and demonstrate true partnership with our provider partners, solidifying Devoted as the health plan of choice and the preferred partner for provider organizations.

In this role, the associate will support the development of a streamlined process for managing payment integrity issues and other escalations from providers. Collaboration with various departments will be essential to identify, triage, and resolve these issues efficiently, ensuring a smooth workflow and maintaining the integrity of payment processes. Expertise will contribute directly to enhancing operational efficiency and fostering a culture of continuous improvement.

Your Responsibilities and Impact will include:

• Act as a point of contact for escalated issues, providing expertise and guidance.

• Support development of a structured process for triaging payment integrity issues and escalations.

• Lead the triage discussions, ensuring that all relevant stakeholders are involved in problem-solving.

• Collaborate with cross-functional teams to identify and prioritize issues based on their impact.

• Monitor the resolution process and provide regular updates to stakeholders on status and outcomes.

• Analyze trends in payment integrity issues and recommend preventative measures.

• Create detailed documentation of issues, resolutions, and processes for future reference and training.

• Facilitate training sessions for team members on new procedures and best practices for issue resolution.

Required skills and experience:

• Strategic analytical horsepower: Proven ability to leverage complex data sets to inform strategic initiatives and team development, while articulating compelling, data-driven narratives that drive organizational vision and ensure alignment.

• Operations minded: define an endpoint and formulate & execute against a plan for getting there, with quantifiable mile markers along the way.

• Relationship builder: expert at building relationships with a broad range of internal and external stakeholders (provider groups).

• Communication skills: conversational agility expertise demonstrated by the ability to reframe, refocus, and redirect conversations to realize accretive partnerships and desired outcomes. Additionally, this individual needs to be able to condense complex concepts into simple explanations with clear and concise calls to action.

• Organization skills: super organized with an eye for detail and the ability to understand and document what matters. Staying organized is a critical component of being able to pivot between going deep into the details and stepping back to see themes or levers that inform strategy.

• Writing Skills: Strong writing ability to craft thoughtful, clear, and persuasive communications to providers, ensuring messages are data-driven and tailored to meet specific needs and contexts.

Desired skills and experience:

• Proven ability to thrive in a fast-paced startup environment

• Capacity for high throughput, while working both autonomously and collaboratively with others

• Proven experience in process development, payment integrity, or issue resolution in a fast-paced environment.

• Strong analytical skills with the ability to identify root causes and develop effective solutions.

• Excellent communication and interpersonal skills to collaborate effectively with various teams.

• Detail-oriented approach with a strong focus on accuracy and quality.

• Ability to manage multiple tasks simultaneously and meet deadlines.

Salary range: $54,000 - $91,000 /year

Our ranges are purposefully broad to allow for growth within the role over time. Once the interview process begins, your talent partner will provide additional information on the compensation for the role, along with additional information on our total rewards package. The actual base salary offered may depend on a variety of factors, including the qualifications of the individual applicant for the position, years of relevant experience, specific and unique skills, level of education attained, certifications or other professional licenses held, and the location in which the applicant lives and/or from which they will be performing the job.

Our Total Rewards package includes:

• 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; Commission eligibility for Sales roles

• Parental leave program

• 401K program

• And more....

*Our total rewards package is for full time employees only. Intern and Contract positions are not eligible.

Healthcare equality is at the center of Devoted’s mission to treat our members like family. We are committed to a diverse and vibrant workforce.

At Devoted Health, we’re on a mission to dramatically improve the health and well-being of older Americans by caring for every person like family. That’s why we’re gathering smart, diverse, and big-hearted people to create a new kind of all-in-one healthcare company — one that combines compassion, health insurance, clinical care, service, and technology - to deliver a complete and integrated healthcare solution that delivers high quality care that everyone would want for someone they love. Founded in 2017, we've grown fast and now serve members across the United States. And we've just started. So join us on this mission!

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.