Director, Utilization Management Operations

Devoted Health • Waltham, MA

5d • $182,000 - $247,000 • Remote

About The Position

Devoted Health is seeking an operationally minded leader to direct the administrative operations supporting its Utilization Management (UM) program. Reporting to the Vice President of Health Services, this leader will manage the onshore UM Administrative Coordinator teams and their leaders, oversee an offshore vendor partnership, and hold dotted-line accountability for Part B medical authorization turnaround times. The role focuses on scaling and improving UM administration while maintaining correct, fair, timely decisions and a thoughtful experience for members and providers.

The Director will lead end-to-end redesign of administrative processes, including authorization intake, requests for additional clinical information, facility census checks, notifications, and follow-up. The role will partner with Product and Engineering to shape the Orinoco technology roadmap and apply integrated AI tools to reduce manual work. In partnership with Data Science, the Director will establish and use measures such as timeliness, cost per authorization, quality, and provider experience to guide performance and improvement.

The position works closely with the Senior Director of UM, UM Medical Directors, Compliance, Provider Network, Data Science, and Engineering. It is fully remote within the 50 U.S. states, with standard working hours in the Eastern Time Zone and semi-annual travel to a Devoted office potentially required. The position offers an annual salary range of $182,000–$247,000. Devoted describes its mission as improving the health and well-being of older Americans by caring for people like family.

Requirements

• Genuine commitment to treating members like family and belief that operational excellence and empathy belong together.
• Track record leading high-volume operations with consistent SLA performance.
• Experience breaking down complex, multi-step processes and leading the development of simpler, more scalable processes.
• Curiosity about why process steps exist and how they can be improved.
• Ability to build measurable processes and work closely with workflows and data to drive decisions and hold teams and partners accountable.
• Experience partnering with product and engineering teams, and genuine interest in using AI-enabled tools to transform work.
• Experience managing vendor partners against clear performance and quality standards.
• Exceptional written and verbal communication skills, including the ability to distill complex problems into actionable updates for leaders and stakeholders.
• Bachelor’s degree required.

Nice To Haves

• Experience in payer operations, utilization management, claims, provider revenue cycle, or a similar high-volume healthcare environment; prior UM experience is not required.
• Understanding of Medicare Advantage operations and CMS requirements.
• MBA or an advanced degree in health administration or finance.

Responsibilities

• Own SLA performance for administrative steps supporting authorization review across UM, with consistent and predictable performance at lower cost.
• Hold dotted-line accountability for Part B medical authorization turnaround times; partner with clinical leaders to monitor performance, surface risks, and remove administrative barriers to timely decisions.
• Map and redesign administrative processes end to end, including authorization intake, requests for additional clinical information, facility census checks, member and provider notifications, and member follow-up.
• Partner with Product and Engineering to shape the Orinoco roadmap and align process and technology development.
• Apply integrated AI tools to reduce manual effort and help administrative capacity scale more slowly than membership.
• Design measurable and transparent processes; partner with Data Science to define and monitor KPIs for timeliness, cost per authorization, quality, and provider experience, and use them for decisions and continuous improvement.
• Lead and develop approximately 50 onshore UM Administrative Coordinators and their leaders.
• Manage the offshore vendor partnership supporting more than 250 administrative team members, setting performance standards and fostering shared ownership and care.
• Partner with the Provider Network team to understand provider and facility needs and incorporate them into the process.
• Design outreach, notifications, and follow-up with members and providers in mind.
• Coordinate with the Senior Director of UM, UM Medical Directors, Compliance, Provider Network, Data Science, and Engineering to keep operations aligned and audit-ready.

Benefits

• Employer-sponsored health, dental, and vision plans with low or no premium.
• Generous paid time off.
• $100 monthly mobile or internet stipend.
• Stock options for all employees.
• Parental leave program.
• 401(k) program.
• Bonus eligibility for roles below Director level; Director-and-above roles are excluded.
• Commission eligibility for Sales roles.

What This Job Offers

• Job Type: Full-time
• Career Level: Director