Senior Compliance Analyst

United States

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Not SpecifiedCompensation

Senior (5 to 8 years)Experience Level

Full TimeJob Type

UnknownVisa

Health Insurance, HealthcareIndustries

Requirements

Candidates must have Health Plan/CMS ODAG auditing experience, the ability to meet strict deadlines, and professional verbal and written communication skills. Travel up to 10% is required. Medicare Advantage experience is strongly preferred, and proficiency in Google products, Jira, and Slack is a plus.

Responsibilities

The Senior Compliance Analyst will report to the Director of Compliance and work across multiple operational teams, including Claims, Payment Integrity, and Appeals. Responsibilities include performing audits, tracking compliance issues, reviewing impact analysis reports, managing corrective action plans, and assisting with day-to-day monitoring activities. The analyst will also support risk assessment and audit planning, review monitoring activities, update policies and procedures, collaborate with departments on compliance activities, analyze data to identify trends and risks, and review regulatory guidance for adherence.

Skills

Compliance

Auditing

Corrective Action Plans

Risk Assessment

Policy Development

Procedure Development

Data Analysis

Regulatory Guidance

Gemini

LLM

Copilot AI

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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