Provider Operations Manager - Credentialing

Devoted Health • Waltham, MA

1d • $73,000 - $115,000

About The Position

The Provider Operations Manager will support and improve the provider and facility credentialing program for Devoted Health’s health plan. This hands-on leadership role combines day-to-day queue work and complex case resolution with process design, operational analysis, AI implementation, and technology improvements. The manager will help scale operations, improve turnaround times and quality, and keep provider data accurate and credentialing compliant as processes evolve.

The role will develop clear standard operating procedures and a current documentation library; help train, monitor, and develop the offshore team; and support transitions of work offshore. It will also contribute to the 2027 CVO vendor transition, including workflow mapping, requirements, testing, cutover, and ongoing vendor performance monitoring. The manager will own operational metrics and reporting, identify bottlenecks and improvement opportunities, and partner with product, engineering, leadership, network and contracting teams, providers, vendors, and offshore partners.

Devoted Health is a healthcare company founded in 2017 with a mission to improve the health and well-being of older Americans. Its integrated care platform combines data and AI with clinical and service experiences. The company describes its workplace as supportive, diverse, and collaborative, and is an equal opportunity employer.

Requirements

• 3–5+ years of experience in operations, process improvement, or consulting.
• Hands-on operational approach and willingness to perform the work, not only direct it.
• Strong process orientation, with the ability to improve efficiency and anticipate and prevent bottlenecks.
• Ability to move between big-picture strategy and detailed execution.
• Ability to reprioritize quickly in a fast-paced, evolving environment.
• Ability to take on complex, difficult problems with persistence.
• Strong attention to detail and commitment to quality and accuracy.
• Ability and willingness to understand and follow complex regulations.
• Strong communication skills and ability to align cross-functional stakeholders.
• Data, systems, and technology skills, including ability to build reporting that improves decision-making.

Nice To Haves

• Healthcare experience.
• Familiarity with credentialing standards and CMS requirements.
• Hands-on experience building and deploying AI tools to improve workflows, or a strong track record applying technology and automation to operational problems.
• Experience with process improvement methodologies.

Responsibilities

• Support day-to-day credentialing operations, work queues, and complex cases while driving strong turnaround times and quality.
• Capture operational knowledge in clear standard operating procedures and maintain a current central documentation library.
• Help manage and develop the offshore team through training, documentation, and quality and productivity monitoring, with the goal of taking ownership of the offshore relationship over time.
• Identify work suitable for offshore transition and support smooth handoffs without disrupting turnaround times or compliance.
• Assess operational pain points, use data to size opportunities, and build business cases for solutions, including measuring the impact of AI, technology improvements, and offshore transitions before and after launch.
• Create and implement AI solutions to improve efficiency and scale, partnering with product and engineering as needed and testing, measuring, and refining solutions.
• Contribute to the 2027 CVO vendor transition through workflow mapping, requirements, testing, and cutover, and monitor vendor performance after launch.
• Develop expertise in internal systems and tools, troubleshoot issues, and propose improvements to system logic.
• Own key operational metrics, build reporting to surface trends and bottlenecks, and use data to guide decisions.
• Maintain compliance with CMS, AAAHC, and state requirements as credentialing processes and tools evolve.
• Partner with internal leadership, network and contracting teams, providers, vendors, and offshore partners.

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.
• Bonus eligibility for roles below Director; Sales roles are eligible for commission.
• Parental leave program.
• 401(k) program.

What This Job Offers

• Job Type: Full-time
• Career Level: Manager
• Education Level: No Education Listed