Senior Manager, Business Operations (Payment Integrity)

Devoted Health • Waltham, MA

1d • Remote

About The Position

A bit about this role: At Devoted, we know that one of the most important ways we will build trust with our network of providers and members is to pay claims accurately and on time while having transparent payment policies. Our Payment Integrity Department ensures that provider claims are paid correctly by the responsible party, for eligible members, according to contractual terms, not in error or duplicate, and free of wasteful or abusive practices. As a Senior Manager, you will be the lead architect of these complex operational flows. You will bridge the gap between high-level strategy and tactical execution, managing a multi-layered ecosystem of vendors and internal tools. We aren't looking for someone to follow a manual; we need a high-velocity operator who can design the roadmap, optimize, and leverage modern technology to scale our impact as we grow.

Requirements

• Bachelor’s degree and 6+ years of professional experience in high-growth operations, strategy, or healthcare management.
• Experience working with data-driven or AI-enabled workflows (no coding required) to drive operational impact.
• Proven ability to drive results across Operations, Product, and Engineering.
• You don't just follow a roadmap; you help build it.
• A strong understanding of the US healthcare ecosystem and its financial "pipes," with the ability to navigate the claims lifecycle even if you aren't a niche billing expert.
• The ability to manage and optimize complex, multi-layered processes across vendors, tools, and teams.
• You are energized by the "messy middle"—you can build processes where none exist and pivot gracefully as the company needs a shift.
• You are equally comfortable presenting high-level strategy to senior leadership as you are rolling up your sleeves to execute tactical daily work.
• Ability to use the company’s vision and values as a North Star when making difficult operational trade-offs.

Nice To Haves

• Proficiency with SQL
• Familiarity with agile methodologies or frameworks for managing complex, cross-functional initiatives

Responsibilities

• Operational Oversight & Performance
• Lead Enterprise Execution: Optimize payment integrity initiatives across internal, vendor, and AI-enabled workflows, maintaining full accountability for prepay and postpay performance.
• Master the Pipeline: Manage the health of audit queues by ensuring work inflow and outflow are accurately forecasted, balanced, and executed against SLA targets.
• Drive Results: Monitor program KPIs—including savings, throughput, and audit yield—taking corrective action and optimizing vendor/AI-supported execution to meet goals.
• Strategic Translation: Convert organizational strategy into actionable operational plans that align with savings targets, audit integrity, and regulatory compliance.
• Scalability & Innovation
• Architect Scalable Solutions: Bridge high-level strategic design with hands-on execution to build repeatable workflows and robust process controls that sustain performance during rapid growth.
• Modernize Workflows: Integrate LLM-driven automation and AI capabilities into operational workflows to streamline manual hand-offs and maximize cost efficiency.
• Continuous Improvement: Use data to identify root causes of inefficiencies across workflows and systems, leading the development of solutions to reduce future operational risk.

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