Director, Claims Operations

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!

A bit about this role: 

This role is key in our organization. At Devoted Health we have the resources, appetite and capabilities to reimagine claims operations as it should be, not how the industry at large has built it and this role will lead that charge. The Director of Claims Operations is an experienced and results-driven leader who will oversee our organization’s claims processing and operations. The ideal candidate will have a deep understanding of health plan claims administration, a proven track record of improving claims efficiency, and the ability to drive strategic initiatives. As the Director of Claims Operations, you will play a critical role in ensuring the accuracy, compliance, and efficiency of our claims processes.

Your Responsibilities and Impact will include:

• Implement strategies to streamline claims operations, reduce processing times, and enhance overall effectiveness
• Ensure claims operations compliance  with regulatory requirements, industry standards, and internal policies
• Own and improve key performance indicators (KPIs) for claims performance of internal and offshore operations
• Work closely with internal departments, including but not limited to; finance, IT, clinical services, network management, compliance, and service, to ensure seamless collaboration and information flow
• Collaborate with stakeholders to address claims-related issues and improvements
• Lead and mentor the claims operations team, fostering a culture of accountability and continuous improvement
• Oversee staff training programs onshore and offshore to enhance skills and ensure adherence to best practices

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 proficiency in data analytics tools
• Strong communication and facilitation skills with all levels of the organization, including the ability to resolve complex issues and build consensus among diverse groups
• Proven leadership competencies in designing, developing and implementing process structure, tools and measurement indicators that drive operational results

Desired skills and experience: 

• Ability  to lead and motivate teams through change and process improvement
• In-depth knowledge of health insurance claims processing, regulations, and compliance requirements
• Proven experience in effectively managing offshore service provider performance and delivery quality

Salary range: $155,000 – $230,000 / a year

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.  If you lack a specific credential for this position but believe that your strengths and life experiences will propel our mission, we would love to hear from you.

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.

The salary and/or hourly range listed is a good faith determination of potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement and may be modified in the future. When determining a team member’s base salary and/or rate, several factors may be considered as applicable (e.g., location, specialty, years of relevant experience, education, credentials, budget and internal equity).

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.

Apply now >