Senior Manager, Health Plan Operations
About The Position
The Business Operations Senior Manager is responsible for the success of Payment Integrity programs and processes. Payment Integrity ensures provider claims are paid correctly by the responsible party, for eligible members, according to contractual terms, and without errors, duplicates, waste, or abuse. The role owns day-to-day operational performance, addresses complex operational problems, and drives results in collaboration with cross-functional stakeholders and teams. The position oversees operational timing, backlogs, queue health, service-level performance, and quality. It designs and launches scalable cross-functional workflows, including testing, change management, training, and post-launch KPI tracking. The role also partners with external vendors and internal teams, identifies opportunities to use AI agents to reduce manual work, and resolves blockers by ensuring teams have the training and job aids needed to succeed. Devoted Health describes its mission as improving the health and well-being of older Americans by caring for everyone like family. Its care platform combines data and AI with clinical and service experiences. The company states that it values diversity, collaboration, change, and advancement, and is an equal opportunity employer.
Requirements
- At least 6 years of experience in business operations or operational leadership.
- Demonstrated success driving meaningful change and measurable operational results in fast-paced environments, with a bias toward action and continuous improvement.
- Ability to execute operational work, manage escalations, and solve problems.
- Comfort with ambiguity and ownership of unanticipated or complex issues from triage through resolution.
- Analytic mindset and ability to conduct qualitative and quantitative analyses that drive impact.
- Exceptional communication and cross-functional collaboration skills, including the ability to influence others.
- Strong organizational skills, including prioritizing and managing multiple initiatives at once.
- High degree of professionalism.
Nice To Haves
- Curiosity about and hands-on experience with AI tools, automation, or LLM-based workflows in operational settings.
- At least 2 years of experience in health tech, digital health, or healthcare technology; Medicare Advantage health-plan and/or startup experience is a plus.
- Experience influencing and driving change in a highly matrixed organization.
Responsibilities
- Monitor daily operational health, including turnaround time, backlogs, and queue performance.
- Oversee operational performance and maintain a feedback loop between productivity and audit accuracy.
- Design, test, and launch scalable cross-functional workflows, including change management, training, and post-launch KPI tracking.
- Partner with external vendors and stakeholders across Engineering, Network/Provider Operations, Claims, and Integrations to align priorities and improve end-to-end workflows.
- Identify and manage opportunities to reduce manual processes by deploying AI agents alongside human staff.
- Serve as the primary escalation point for vendor and internal-team blockers, ensuring teams have the training and job aids they need.
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; commission eligibility for Sales roles.
- Parental leave program.
- 401(k) program.
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What This Job Offers
Job Type
Full-time
Career Level
Senior
Education Level
No Education Listed
