[Remote] Senior Associate, Operations at Devoted Health

United States

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Not SpecifiedCompensation

N/AExperience Level

N/AJob Type

Not SpecifiedVisa

N/AIndustries

Requirements

2+ years of professional experience
At least 1 year in a healthcare administrative, healthcare compliance or billing support role
Familiarity with EHR systems and reviewing documentation for accuracy
Excellent communication skills
Familiarity with Medicare Advantage requirements
Strong working knowledge of claims processes and billing requirements
Attention to detail and ability to work on multiple projects
Interest in and/or experience with basic data analysis (e.g., Excel/Sheets formulas, pivot tables, or SQL) (Desired)
Ability to generate and interpret reports in tools like Looker or similar BI platforms (Desired)
Curiosity about technology in healthcare, including tools like large language models (LLMs) (Desired)
Strong experience using Google Workspace (Docs, Sheets, Drive, Gmail, Calendar, Meets) (Desired)

Responsibilities

Oversee day-to-day activities and support healthcare operations
Oversee policy adherence
Oversee process improvement
Oversee claims management
Monitor key metrics
Analyze operational and compliance trends
Prepare routine reports and make recommendations for improvements
Oversee the verification and maintenance of policies, procedures, and knowledge base resources
Identify workflow inefficiencies and recommend process solutions
Lead small-to-medium cross-functional projects
Support other organizational priorities by coordinating and executing special projects
Develop and maintain training guides, SOPs, or quick reference materials
Collaborate on the design and delivery of annual compliance training for clinical staff
Review claim submissions
Conduct regular reviews of claim denials
Track trends and share actionable insights with leadership on a monthly basis
Ensure timely review and resolution of denied or adjusted claims
Provide training on billing processes, telehealth service requirements, and denial management
Support billing needs for new clinical programs
Partner with Sr Mgr, Practice Operations to monitor, report and own key metrics in the Policy Adherence space
Collaborate with clinical staff and leadership to ensure compliance and efficiency

Skills

Devoted Health

Medicare Advantage plans with personalized support

About Devoted Health

Devoted Health provides Medicare Advantage plans aimed at simplifying and making healthcare more affordable for seniors aged 65 and older. Their plans include services like provider and pharmacy searches, prescription drug coverage, and preventive care rewards. Members pay premiums for these plans, and the company may also receive government payments for managing Medicare benefits. What sets Devoted Health apart from competitors is their high level of customer service, featuring Devoted Health Guides who assist members in navigating their healthcare options and addressing common issues with traditional insurance. Additionally, they promote preventive care through the Devoted Dollars program, which rewards members for engaging in health activities. The goal of Devoted Health is to create a more compassionate and accessible healthcare experience for its members.

Waltham, MassachusettsHeadquarters

2017Year Founded

$2,194.5MTotal Funding

SERIES_ECompany Stage

HealthcareIndustries

1,001-5,000Employees

Benefits

Comprehensive health plan

401(k) retirement plan

Generous vacation and holiday time

Lyra mental health resources

Time off to vote

Risks

Increased competition from Medicare Advantage providers like Clover Health and Oscar Health.

Potential regulatory changes affecting Medicare Advantage plans by CMS.

Rising healthcare costs could impact the affordability of Devoted Health's plans.

Differentiation

Devoted Health offers personalized assistance through Devoted Health Guides for member support.

The company emphasizes preventive care with its Devoted Dollars rewards program.

Devoted Health integrates virtual and in-home care with top local providers.

Upsides

Devoted Health raised $287 million in Series E funding in 2024.

The company expanded Medicare Advantage plans to eight new states in 2023.

Devoted Health achieved a 5-star Medicare Advantage rating in Ohio in 2023.

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