Senior Manager, Provider Escalation and Education

Devoted Health • Waltham, MA

9d • $110,500 - $150,000 • Remote

About The Position

The Provider Escalation & Education (Prov Esc/Edu) team is dedicated to maintaining strong operational relationships with our Critical Provider Organizations (CPOs) while focused on building partnerships that reduce frustration through efficient issue management and proactive solutions. Our mission is to minimize unnecessary friction and demonstrate true partnership with our provider partners, solidifying Devoted as the health plan of choice and the preferred partner for provider organizations. We’re looking for an exceptional leader to own and evolve the operational transformation of our Network Escalations (provider escalations via their network team contact) function. AI automation, digital workflows, and self-service are changing the cost and quality curve of operational work, creating a unique opportunity to reimagine Network Escalations as a modern, technology-enabled engine that delivers better provider experience, faster responses to complex problems, upstream issue detection, and stronger quality. In this role, you’ll lead both the team and the day-to-day operational excellence of our Provider Complex Case Team that handles Network Escalations and the design, implementation, and ownership of its next-generation operating model. We’re looking for a systems-minded operator who can own outcomes end to end — a true builder-operator who can lead a service organization today while designing, implementing, and owning the workflows, systems, and tooling that will define how the function operates in the future. A key responsibility will be direct engagement with critical provider groups during escalations, including face-to-face meetings to build trust, resolve issues, and reinforce long-term relationships. Additionally, by driving upstream operational initiatives, the Sr. Manager will identify key pain points and collaborate with cross-functional teams to charter and implement innovative program solutions that mitigate future escalations and improve overall operational performance. This role is pivotal in fostering a culture of proactive problem-solving and continuous improvement within the team. The best candidate will combine operational excellence, systems thinking, obsession with detail, pace- setting execution, and the ability to create confidence through change. This role is ideal for someone who organizes around metrics and outcomes, runs to hard problems, has a strong track record of achieving results, and thrives in ambiguity while building durable systems that outlast any one leader.

Requirements

• At least 5 years of leadership experience with a track record of delivering measurable outcomes in complex operational environments
• Outstanding operational rigor with the ability to deploy technology to solve complex business challenges
• Proven experience driving end-to-end initiatives from strategy through execution that materially improve quality, service levels, cost, compliance, or operational efficiency
• Demonstrated ability to manage through metrics, establish ambitious targets, and drive teams to results with clear accountability
• Exceptional attention to detail and precision, with a reputation for sweating the details and getting the hardest operational last mile right
• Clear evidence of urgency, resilience, and the ability to move quickly while maintaining high quality standards
• Proven ability to leverage complex data sets to inform strategic initiatives and team development, while articulating compelling, data-driven narratives that drive organizational vision and ensure alignment.
• Expert at building relationships with a broad range of internal and external stakeholders (provider groups).
• Conversational agility expertise demonstrated by the ability to reframe, refocus, and redirect conversations to realize accretive partnerships and desired outcomes. Additionally, this individual needs to be able to condense complex concepts into simple explanations with clear and concise calls to action.

Nice To Haves

• Experience transforming operations through AI-enabled workflows
• Proven ability to thrive in a fast-paced startup environment
• Capacity for high throughput, while working both autonomously and collaboratively with others
• Track record of success becoming an expert with a tool or system that was unfamiliar to you

Responsibilities

• Ownership of Devoted’s Network Escalations function, including service levels, quality, provider experience, operational performance, compliance, and cost
• Leading a team of subject matter experts that resolve network escalations
• Running the current machine while designing, implementing, and owning the future-state machine
• Defining and executing the roadmap for modernizing through AI, workflow automation, and self-service
• Establishing clear visibility into units of work, productivity, quality, cost, and performance metrics
• Meet with providers to resolve escalations and deliver proactive performance insights, actively engaging to understand their needs and challenges.
• Building and operationalizing AI-enabled and human-in-the-loop workflows that improve quality, consistency, speed, and provider satisfaction
• Managing the function through rigorous metrics, KPIs, scorecards, and performance dashboards, with clear accountability for outcomes
• Partnering cross-functionally with Network and other health plan operations teams to solve upstream drivers of provider issues and improve end-to-end provider experience
• Leading through significant evolution while creating confidence, momentum, stability, and strong culture through change
• Raising the talent bar across the organization by setting the pace and modeling high standards

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
• And more....
• Our total rewards package is for full time employees only. Intern and Contract positions are not eligible.

What This Job Offers

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