Note: The job is a remote job and is open to candidates in USA. Devoted Health is a healthcare company focused on improving the health and well-being of older Americans through integrated care, data, and technology. The Senior Manager, Provider Operations will own provider data and directory accuracy, ensure regulatory compliance, lead a hybrid team, improve data quality infrastructure, and partner with cross-functional teams to advance care navigation and operational automation.
Responsibilities
- Own provider data accuracy end to end — validation, verification, exception handling, and remediation across roster intake, credentialing, and downstream publication to our member-facing directory
- Serve as the accountable owner for provider directory compliance, including CMS Medicare Advantage directory accuracy and verification requirements, online directory obligations. Maintain audit-ready documentation and lead our response to regulatory inquiries and audits
- Lead, manage, and grow a hybrid onshore and offshore team — hiring, onboarding, training, quality assurance, capacity planning, and performance management — building the structure and documentation that let the team scale without a linear increase in headcount
- Operate and improve our signal-driven accuracy infrastructure, using scoring and prioritized verification queues to focus outreach where the risk to members and to compliance is highest
- Define, instrument, and report the metrics and SLAs for provider data accuracy; deliver clear, credible reporting to executive stakeholders and translate results into a prioritized roadmap
- Shape directory strategy — partner with product, engineering, and network leaders to evolve the directory from a compliance artifact into a care navigation tool that helps members find high quality, accessible providers
- Support care navigation initiatives by ensuring the underlying data that drives steerage decisions is accurate and complete, including specialty, panel status, accepting-new-patient indicators, location, and PCP assignment
- Partner with product and engineering to automate manual validation work, and evaluate and manage vendor relationships supporting provider data and directory accuracy
Skills
- Bachelor's degree and a minimum of 6 years of relevant experience, including at least 2 years directly managing a team
- Experience at a health plan or in healthcare operations, with hands-on ownership of provider data, provider directory, credentialing, or network operations
- Working knowledge of the regulatory environment governing provider directories — CMS Medicare Advantage directory and network adequacy requirements, and comfort reading and operationalizing regulatory guidance
- Proficient in analyzing data sets to generate insights and turn those insights into action
- Demonstrated success building repeatable operational processes with measurable quality outcomes, including QA frameworks and documented workflows
- Strong communication skills to facilitate collaboration and influence stakeholders across compliance, network, product, and engineering
- Exceptional organizational skills, adept at prioritizing tasks effectively to consistently meet deadlines
- Experience managing or scaling offshore and/or vendor delivery teams
- Experience applying AI and automation to reduce manual operational work
- Experience leading or supporting a regulatory audit or corrective action plan
- SQL or equivalent ability to query and validate provider data directly
- Thrives in a fast paced, metrics driven environment and is comfortable with ambiguity
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
- The total rewards package is for full time employees only; Intern and Contract positions are not eligible.
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