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 Utilization Management (UM) Program Design and Insights Senior Manager drives the design and ongoing refinement of Devoted’s best-in-class UM Program, a program designed to enable members to quickly and safely get the care they need at the right time, in the right place. This role partners with UM leadership, Data Science, Business Intelligence, and Medical Economics to improve forecasting of UM program design impact and improve the monitoring thereof. This role liaises with UM leadership to assure organizational understanding of the linkages between operations and outcomes and to refine operational workflows, KPIs, and targets accordingly. This role proactively surfaces opportunities and engages in cross-functional discussions accordingly to pursue non-UM levers to reduce inappropriate care including (e.g., Payment Integrity, provider engagement, network sculpting). This role is responsible for driving organizational understanding of the impact of the team’s work to inform a data-driven program design.

The ideal candidate is a self-starter who can effectively and proactively analyze data, establish and monitor KPIs for program effectiveness, build relationships with internal and external stakeholders, and consistently strive for improved outcomes.

Your Responsibilities and Impact will include:

• Drive innovative and relevant UM program design and strategy, accounting for historical results and intel from evolving regulatory and industry landscape

• Set, monitor, and as relevant evolve KPIs to measure UM program effectiveness

• Deepen organizational understanding and forecasting, in partnership with Medical Economics and Data teams, of the downstream impact of UM operations

• Partner with UM leadership to review opportunities for improved operational excellence

• Perform frequent, extensive analysis of results to inform program design decisions

• Proactively identify opportunities for new or refined UM policies

• Proactively identify non-UM opportunities to reduce inappropriate care

• Effectively frame, facilitate, and drive decision making in discussions with cross-functional and executive leadership
  

Required skills and experience:

• Bachelor's Degree or equivalent experience

• Analytic, problem-oriented mindset with comfort and ability to effectively deal with ambiguity

• High degree of influence and exceptional stakeholder engagement skills

• 5+ years of experience influencing and driving change in a highly-matrixed organization

• Cross-functional project management and facilitation proficiency

• Strong written and oral communication skills and high degree of professionalism

Desired skills and experience:

• Thrives in high-speed environment in a role with a high degree of ambiguity

• Results-oriented with a willingness to take initiative and get the job done

• 5+ years of Medicare Advantage operations experience and familiarity with UM operations (and/or a willingness to learn and ability to do so quickly and effectively)

• Ability to cultivate positive energy and maintain positive working relationships across Devoted teams and external partners

Salary range: $104,500 - $154,600 annually

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.