Jobs at Devoted Health

Identify, engage, and contract healthcare providers to build and maintain a Medicare Advantage network within a geographic region. Manage outreach, negotiate and execute standard agreements, track documentation and workflows, collaborate with Legal, Credentialing, Finance and Market teams, use data to support negotiations, and drive process improvements to meet network adequacy and growth goals.

Manage day-to-day operations of the Risk Adjustment External Audit program across Retrieval, Evaluation, and Submission workstreams. Improve processes, support cross-functional audit responses, build AI-native KPI monitoring, analyze data, communicate risks and status to stakeholders, and support special projects to drive operational excellence.

Lead and execute end-to-end provider network contracting across Commercial and Medicare Advantage lines. Close complex negotiations with physician groups and ancillary providers, optimize fee schedules and pricing, and operationalize agreements with Provider Ops, Claims, and Credentialing. Build and mentor a high-performing contracting team, standardize playbooks, and leverage AI-assisted tools and data visualization to accelerate deal execution and reporting. Collaborate cross-functionally with Actuarial, Underwriting, Product, and Sales to support market expansion and competitive pricing.

Supervise mid-level providers in Ohio to meet state supervision requirements. Ensure delivery of evidence-based clinical care and maintain an active medical license.

Supervise mid-level providers in South Carolina, ensuring compliance with state supervision requirements, and participate in biannual meetings for chart reviews.

Lead data science across Growth and Membership Operations: define problems, build scalable data models and pipelines, develop analytical and ML solutions, partner cross-functionally, and integrate AI tools to optimize sales, marketing, telesales, and enrollment operations.

The Business Applications Manager will oversee the financial tech stack, focusing on NetSuite administration, internal controls, and process improvements while managing projects and cross-functional communication.

The role involves supervising APRNs in Mississippi, ensuring compliance with state requirements, and participating in board meetings. Must maintain an active medical license and practice in Mississippi.

Supervise mid-level providers to meet Georgia's requirements, conduct quarterly meetings, ensure evidence-based clinical care, and maintain a valid medical license.

The Collaborating Physician Contractor supervises mid-level providers in Alabama, ensuring they meet supervision requirements and maintain clinical care quality. Responsibilities include in-person quarterly meetings and compliance with evidence-based guidelines.

Design and manage the full lifecycle of payment integrity edits and audits, converting CMS, AMA/CPT, and coding regulations into rule logic. Validate hypotheses using data queries, author technical specifications, optimize post-release performance, adopt LLM/AI workflows, map regulatory policy, and coordinate cross-functionally to ensure defensible, efficient claims processing.

Lead design and delivery of enterprise capabilities within Devoted's Orinoco platform. Build integrations, APIs, and automations to streamline operations, ensure compliance, enable data access, and reduce operating costs while partnering with HR, Finance, Security, and Tech teams.

Support daily cash management and liquidity across corporate and regulatory entities by processing ACH files, wire transfers, and bank reporting. Reconcile daily bank reports, assist monthly close and audit preparation, maintain treasury documentation, and recommend banking services and controls. Participate in strategic projects and automate treasury processes using AI tools.

Perform detailed QA and editing of member-facing and internal content across channels (SMS, email, portal, letters, knowledge base). Simplify complex healthcare content into plain language, maintain consistency and compliance, write and revise copy, interact with AI agents to streamline workflows, meet high-volume deadlines, and collaborate with content strategists. Portfolio required.

Lead and perform end-to-end technology audits across cloud, cybersecurity, and AI environments. Design audit methodology and tooling, apply data analytics and AI to testing, assess AI governance and IT controls, manage stakeholder relationships, ensure IIA Standards compliance, and coach junior auditors while delivering findings to senior leadership.

Lead finance operations for provider risk-sharing and reinsurance arrangements: own settlement, accounting, forecasting, reserves and reporting; partner cross-functionally (actuarial, claims, network, data, engineering, legal) to design controls, policies, reconciliation, dispute resolution, and regulatory/audit responses; support provider relationships and analytic tooling to monitor performance and payments.

The Senior Manager, AI Performance & Operations is responsible for the performance and improvement of AI workflows, incident response, designing evaluation systems, and stakeholder communication.

The Provider Network Manager develops and manages provider networks, negotiates contracts, supports quality measures, and enhances member outcomes in healthcare for an assigned area.

Perform prospective, concurrent, and retrospective utilization reviews for inpatient, behavioral health, and post-acute services against CMS and Medicare Advantage criteria; assess medical necessity and level of care; prepare cases for Medical Director review and coordinate peer-to-peer discussions; document determinations, ensure regulatory compliance, and monitor resource stewardship to optimize member care and appropriate utilization.

Provide telephonic and virtual social work case management for high‑needs patients: assess social determinants, develop personalized care plans, coordinate community and clinical resources, support caregivers, facilitate advanced care and palliative/hospice planning, and collaborate with an interdisciplinary team to improve outcomes.