Payment Policy Program Manager

At Devoted Health, we’re on a mission to dramatically improve the health and well-being of older Americans by caring for every person like family. That’s why we’re gathering smart, diverse, and big-hearted people to create a new kind of all-in-one healthcare company — one that combines compassion, health insurance, clinical care, service, and technology - to deliver a complete and integrated healthcare solution that delivers high quality care that everyone would want for someone they love. Founded in 2017, we've grown fast and now serve members across the United States.  And we've just started. So join us on this mission!

Job Description

A bit about this role: 
 

The role of Payment Policy Program Manager is vital within our organization, especially as we continue to evolve and mature. The necessity for clear and strategic decision-making cannot be understated, particularly concerning the financial and operational efficiency that supports our ongoing success and growth. The ideal candidate is primarily responsible for overseeing and managing the development, implementation, and continuous refinement of payment policies that govern the financial transactions between Devoted, providers, partners and members.

Your Responsibilities and Impact will include:

• Manage Devoted Health’s Payment Policy Program from start-to-finish, including but not limited to topic insourcing and prioritization, policy development and execution, post implementation process oversight

• Own reimbursement policy program process improvement

• Identify medical cost saving opportunities and trends through reimbursement policy program oversight, auditing, and efficacy evaluations

• Manage and report on reimbursement policy programs performance

• Partner with stakeholders across the organization including but not limited to clinical, networks, markets, provider relations and medical management to drive strategic priorities and initiatives

• Prioritize reimbursement policy priorities based on financial impact, ease of administration/implementation, regulatory requirements, etc.

Required skills and experience: 

• Bachelor's degree in Health Administration, Business, or equivalent combination of experience and education 

• Extensive experience (8+ years) in operations, with a focus on leadership and strategy

• Strong analytical and problem-solving skills, with fluency in google-sheets/excel, ability and desire to learn new tools (e.g., looker explorer, snowflake), and experience working with data analytics team on more involved data asks

• Strong communication and facilitation skills with all levels of the organization, including the ability to resolve complex issues and build consensus among diverse groups. Ability to lead and motivate teams through change and process improvement

• Proven leadership competencies in designing, developing and implementing process structure, tools and measurement indicators that drive operational results

• Some knowledge of health insurance claims processing, regulations, and compliance requirements

Desired skills and experience:

• In-depth knowledge of health insurance claims processing, regulations, and compliance requirements

Salary Range: $76,000 - $110,000 / year

Our ranges are purposefully broad to allow for growth within the role over time. Once the interview process begins, your talent partner will provide additional information on the compensation for the role, along with additional information on our total rewards package. The actual base salary offered may depend on a variety of factors, including the qualifications of the individual applicant for the position, years of relevant experience, specific and unique skills, level of education attained, certifications or other professional licenses held, and the location in which the applicant lives and/or from which they will be performing the job.

Our Total Rewards package includes:

• 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.

Healthcare equality is at the center of Devoted’s mission to treat our members like family.  We are committed to a diverse and vibrant workforce. 

Devoted is an equal opportunity employer. We are committed to a safe and supportive work environment in which all employees have the opportunity to participate and contribute to the success of the business. We value diversity and collaboration. Individuals are respected for their skills, experience, and unique perspectives. This commitment is embodied in Devoted’s Code of Conduct, our company values and the way we do business.

As an Equal Opportunity Employer, the Company does not discriminate on the basis of race, color, religion, sex, pregnancy status, marital status, national origin, disability, age, sexual orientation, veteran status, genetic information, gender identity, gender expression, or any other factor prohibited by law. Our management team is dedicated to this policy with respect to recruitment, hiring, placement, promotion, transfer, training, compensation, benefits, employee activities and general treatment during employment.