Senior Data Submissions Operations Associate

Devoted Health • Waltham, MA

2d • $55,000 - $90,000 • Remote

About The Position

We are seeking a meticulous and technically skilled Operations Senior Associate to lead the preparation, submission, and quality control of healthcare data and medical records to support normal operations and special projects. Special projects include CMS Risk Adjustment Data Validation (RADV) audits and Part C Improper Payment Measurement audits. This role is responsible for ensuring that all submissions to CMS are timely, accurate, compliant, and fully documented. You will act as one of a limited number of users of CMS data abstraction and data processing systems and serve as the primary liaison between Devoted Health, CMS, and internal technical teams. The ideal candidate combines operational precision and technical troubleshooting ability with strong awareness, compliance, and discipline handling sensitive healthcare data to ensure our submissions meet the highest quality standards—especially during high volume periods.

Requirements

• Proven experience in healthcare data submissions, medical record management, or health information operations, ideally in a Medicare Advantage or risk adjustment audit environment.
• Strong attention to detail with the ability to perform meticulous QA under time‑sensitive conditions.
• Ability to troubleshoot technical submission errors and partner effectively with IT and technical teams.
• Strong organizational skills and experience managing high‑volume workflows with compressed timelines.
• Experience collaborating with offshore resources or distributed teams, with the ability to clearly communicate priorities and task requirements without direct managerial authority
• Excellent communication and collaboration skills for working with cross-functional teams.

Nice To Haves

• Bachelor’s degree in Healthcare Administration, Health Information Management (HIM), Business, or related field. Relevant professional experience will be considered in lieu of a bachelor's degree.
• Proficiency with SQL, Looker, or other BI/database query tools for analyzing and validating submission data huge plus
• Experience working with CMS systems such as the Central Data Abstraction Tool (CDAT), Encounter Data Processing System (EDPS), or similar healthcare submission portals including familiarity with ICD‑10 coding or risk adjustment data.

Responsibilities

• Own the end‑to‑end audit file submission process, including file validation, coversheet completion, and final upload via CMS portal.
• Coordinate and direct day‑to‑day work activities of assigned team members for submission‑related tasks, ensuring priorities, timelines, and quality standards are met; partner with Devoted’s internal management team to align assignments and resolve resource issues.
• Conduct detailed quality assurance checks on all files, ensuring alignment with CMS specifications (naming conventions, file size limits, date visibility, provider credentials, and document legibility).
• Monitor and triage submission feedback, routing issues to coding, file prep, compliance, or audit teams as appropriate.
• Maintain meticulous tracking of submission status, metadata, and resolution notes in internal audit logs.
• Partner closely with internal Tech and IT Submission teams to resolve system issues, optimize processes, and manage secure file transfers.
• Prepare and deliver submission metrics, error trends, and resolution summaries for RADV operations reporting; leverage SQL, Looker, or other BI tools to extract and analyze submission data where appropriate.
• Document and update standard operating procedures (SOPs) for submission, QA, and feedback resolution to ensure operational consistency.

Benefits

• 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

What This Job Offers

• Job Type: Full-time
• Career Level: Senior
• Education Level: Associate degree