You will lead the strategic and operational aspects of outbound engagement functions, focusing on program design, workflow optimization, and performance management. You will also partner with senior stakeholders and clinical leaders to drive member outreach initiatives and mentor a team of managers and guides.
The specialist is responsible for identifying, negotiating, and executing provider contracts within an assigned geographic region to build and maintain a high-quality network. They will partner cross-functionally with internal teams to resolve contracting issues and ensure network adequacy.
The specialist will analyze provider demographic and financial data to support performance meetings and execute provider audits. They will also manage the contract lifecycle for provider onboarding and resolve field performance issues.
The Agent Support Associate serves as a primary point of contact for Medicare Advantage broker partners, providing support across the enrollment and post-enrollment lifecycle. Responsibilities include answering inquiries, resolving complex issues, and collaborating with internal teams to ensure accurate and timely service.
The Payroll Analyst will manage end-to-end bi-weekly payroll processing, including data analysis, tax compliance, and system integrity within Workday and ADP. They will also serve as the primary point of contact for employee payroll inquiries and support the finance team with reporting and audit preparation.
The Clinical Documentation Manager serves as a subject matter expert to drive clinical documentation integrity and coding accuracy across the enterprise. They will lead provider education initiatives, support audit responses, and collaborate with cross-functional teams to implement AI-assisted workflows.
The provider will perform virtual acute care visits, including diagnosing illnesses, ordering diagnostic tests, and establishing collaborative care plans. They will work closely with the member's care team, including PCPs, specialists, and nursing staff, to coordinate effective treatment.
The manager will oversee practice operations for a home-based and telehealth medical group, including building clinical infrastructure and managing staff. They are responsible for designing efficient workflows, managing logistics, and tracking operational and financial performance to ensure high-quality patient care.
The Medical Economist leads strategic and operational efforts to optimize medical cost management and total cost of care across Commercial lines of business. This role bridges financial strategy and operational execution by modeling provider contracts, ensuring accurate claims adjudication, and delivering actionable intelligence to executive leadership.
The Provider Network Performance Manager will drive provider performance across Oregon and Washington by analyzing data to identify gaps and developing targeted improvement plans. This role involves building strong relationships with medical groups and health systems to ensure alignment on cost, quality, and network access goals.
The Clinical Guide performs prospective, concurrent, and retrospective utilization reviews to evaluate the medical necessity and appropriateness of inpatient and post-acute services. They collaborate with medical directors on complex cases and ensure all documentation complies with CMS and Medicare Advantage regulatory standards.
The role involves conducting clinical audits and monitoring utilization management operations to ensure compliance with regulatory standards and organizational policies. Additionally, the position serves as a clinical education resource, identifying knowledge gaps and supporting staff training to improve overall clinical decision-making.
The strategist will design and execute enterprise reinsurance architecture and optimize statutory capital strategies across regulated insurance entities. They will also manage relationships with regulators, brokers, and internal leadership to ensure capital efficiency and regulatory compliance.
Lead the end-to-end strategy, modeling, and submission of Medicare Advantage Part C and Part D bids, ensuring accurate pricing and compliance with CMS requirements and deadlines. Partner with product, clinical, finance, analytics, and market teams to develop assumptions, assess scenarios, maintain reliable models and data, and communicate bid strategy and financial outcomes to executives and regulators.
Lead the strategy, development, and execution of Commercial pricing models and rating processes, including group, ASO, and stop-loss pricing. Direct state rate filings and regulatory engagement while partnering with underwriting, finance, sales, clinical, and network teams to support profitable and compliant pricing.
The Transitions of Care Associate supports members post-discharge by coordinating services such as transportation, meals, and home health care. They also facilitate communication between patients, providers, and caregivers to ensure safe recovery and prevent hospital readmissions.
Lead the Payment Integrity disputes and appeals team, managing queue operations, service levels, quality, training, and complex claim escalations. Analyze dispute trends and root causes, improve upstream edits and policies, maintain audit readiness, report performance to leadership, and support provider education and process automation.
Plan and execute sales operations initiatives, analyze operational pain points involving sales compensation and software integrations, and measure results to sustain improvements. Conduct analytics and modeling, coordinate stakeholders and concurrent projects, and support data-driven optimization of the multi-channel sales force.
Lead Devoted Health’s provider escalation function, owning response time, quality, resolution, performance metrics, and the development of scalable future-state processes. Align cross-functional teams and executives, build AI-enabled and automated workflows, and drive initiatives that address root causes and prevent escalations.
The Senior Manager will lead a high-performing team of nurses and care coordinators to ensure safe and effective transitions for patients post-hospitalization. They are responsible for driving clinical outcomes, managing staff performance, and providing direct patient care for 10-20% of their time.
You will build product features across a range of technologies while collaborating with subject matter experts to design solutions that improve members' lives. Additionally, you will work with the technology team to enhance the platform and ensure operational efficiency.
The Medical Director will lead the clinical strategy and operations for virtual urgent care, primary care extension, and virtual observation services. This role involves building and managing interdisciplinary teams, overseeing technology integration, and ensuring high-quality care delivery across digital channels.
The Care Coordinator supports clinical operations by managing patient outreach, scheduling post-discharge follow-ups, and coordinating clinical documentation. They also assist with technology preparation for telehealth visits and collaborate with clinical teams to prevent readmissions.
The supervisor leads a team of Transitions of Care (TOC) Coordinators to ensure patients receive necessary support during hospital-to-home transitions. Responsibilities include managing team performance, developing workflows, facilitating training, and providing direct patient care for 30% of the time.
The Senior Financial Analyst will architect and scale cost accounting frameworks, including expense allocation and profitability analysis to guide margin optimization. They will also build driver-based financial models and support cross-functional teams in continuous process improvement and reporting standardization.
The Palliative Care NP Manager provides expert clinical care and direct supervision to palliative care staff while managing patient referrals and clinical workflows. They act as a player-coach to model clinical excellence, conduct performance reviews, and drive process improvements within the program.
The provider will perform comprehensive post-discharge assessments and manage acute/urgent symptom visits for medically complex patients. They will also collaborate with an interdisciplinary team to adjust care plans and contribute to program development and quality improvement initiatives.
The Clinical Readmission Manager conducts prepayment and post-payment clinical reviews of inpatient hospital admissions to determine if readmissions are clinically related and preventable. The role involves preparing objective clinical determinations, managing appeal documentation, and collaborating with internal teams to ensure accurate and compliant audit outcomes.
The provider will perform initial assessments, develop palliative plans of care, and follow a longitudinal panel of high-risk patients via telephonic and video encounters. They will also collaborate with interprofessional teams to manage symptoms, facilitate hospice transitions, and support program development.
The Program Manager oversees inpatient payment integrity programs, including audits, appeals, and quality processes to ensure regulatory compliance and operational efficiency. They provide guidance to internal and external teams while managing program metrics and driving continuous improvement efforts.
The provider will perform comprehensive post-discharge assessments and manage the clinical trajectory of medically complex patients over a 30-day window. They will also collaborate with an interdisciplinary team to prevent readmissions and contribute to program development and quality improvement initiatives.
The manager will oversee clinical data acquisition by developing strategies to improve data availability and usability across healthcare systems. They will collaborate with internal and external stakeholders to implement technical integrations and ensure data quality through effective KPIs.
You will build and manage AI-powered systems to monitor and improve the quality of member interactions across frontline teams and AI agents. This role involves defining performance standards, creating coaching workflows, and partnering with leadership to drive actionable insights and operational excellence.
The Digital Marketing Associate will build and deploy multi-channel digital marketing campaigns while coordinating with external vendors and internal creative teams. They are responsible for tracking channel performance using data tools and ensuring all marketing materials are compliant and error-free.
The Member Flex Guide serves as a primary bridge for English and Spanish-speaking members, helping them navigate healthcare complexities with empathy and precision. Responsibilities include engaging across multiple communication channels, conducting proactive clinical outreach, and maintaining accurate documentation while adhering to regulatory compliance.
Guides act as the primary connection for members, helping them navigate healthcare complexities through inbound service, proactive outreach, and digital support. They must maintain operational excellence by leveraging AI tools and internal systems while adhering to HIPAA and compliance standards.
The Pharmacy Guide manages high-volume outbound calls to help members overcome barriers to medication adherence and access necessary care programs. They are responsible for building trust, investigating member issues, and coordinating with clinical teams to ensure continuity of care.
Manage high-volume outbound phone calls to engage members in medication adherence and health support programs. Investigate member issues, identify root causes, and coordinate with clinical teams to resolve needs.
The Palliative Care Social Work Case Manager provides supportive counseling and care coordination for patients with complex needs and life-limiting illnesses. Responsibilities include conducting psychosocial assessments, facilitating goals of care discussions, and collaborating with an interdisciplinary team to eliminate socioeconomic barriers.
The nurse will provide virtual, home-based palliative care through telephonic and video engagement while managing patient panels and coordinating care with interdisciplinary teams. Responsibilities include performing triage, conducting routine health check-ins, and supporting palliative education initiatives.
The Medical Director will design and lead the clinical architecture for a national Musculoskeletal (MSK) program, integrating AI-driven workflows with high-touch patient care. This role involves building and managing a clinical team, defining care pathways, and measuring outcomes to ensure high-quality, scalable MSK services.
Conduct comprehensive telehealth assessments and provide evidence-based preventative care for members. Collaborate with an interdisciplinary team to manage chronic conditions and coordinate whole-person care plans.
Own provider data accuracy and directory compliance end to end, including validation, verification, remediation, audit readiness, and regulatory responses. Lead and scale a hybrid onshore/offshore team, improve data-quality operations and reporting, and partner with product, engineering, and network leaders to advance directory strategy and automate manual work.
The Community Outreach Specialist will build strategic relationships with community influencers to secure prospecting venues and orchestrate sales and marketing events. They will also collaborate with Broker Managers to align outreach strategies and provide mentorship to external agents on lead-generation techniques.
The Pharmacy Care Coordinator supports clinical outreach campaigns by managing member appointments and coordinating medication therapy changes with providers and pharmacies. They also manage an assigned caseload to address clinical gaps, medication concerns, and cost-saving opportunities for members.
The Senior Stock Plan Administrator will own and manage the company's equity plan operations, including grant processing, cap table management, and liquidity events. They will also lead the implementation of equity tools, ensure tax compliance, and provide guidance to employees regarding their equity compensation.
The Senior Manager oversees daily operations and long-term strategy for inbound correspondence and outbound print production. This role acts as a bridge between membership operations and core health plan functions while managing vendor relationships and departmental budgets.
The Clinical Associate acts as a liaison between healthcare services and members, coordinating care, managing medical records, and facilitating appointments. They support clinicians by identifying care gaps, communicating with providers, and providing high-touch telehealth support to ensure positive health outcomes.
Provide remote telehealth care and manage patients in a virtual observation unit to improve health outcomes. Supervise and teach a team of advanced practice providers while fostering a collaborative clinical environment.
The manager will provide clinical care to patients while overseeing the clinical and operational performance of the Transitions of Care APP team. Responsibilities include performance management, KPI tracking, process improvement, and team leadership to ensure clinical excellence.
The manager evaluates drug cost, safety, and integrity opportunities across Part B and Part D to identify and solve patterns of waste or inefficiency. They build clinical and financial cases for viable opportunities and collaborate with internal functions to implement solutions.
Provide comprehensive virtual primary care visits, including chronic disease management, preventive screenings, and acute care interventions. Collaborate with a multidisciplinary team to coordinate diagnostics, specialist referrals, and individualized care plans.
The Provider Network Performance Manager will drive provider performance across the New York market by analyzing data to identify gaps and developing improvement plans. This role involves leading provider partnerships, managing Joint Operating Committees, and aligning contracting strategies to meet cost, quality, and access goals.
The Senior Treasury Manager will partner with the Treasury Director to lead cash management, debt portfolio oversight, and treasury infrastructure development. This role involves managing international banking relationships, liquidity forecasting, and ensuring compliance with financial regulations and internal controls.
The Senior Director of Interoperability will define the multi-year vision for data exchange and lead the operational teams responsible for clinical data integration and compliance. This role involves aligning cross-functional stakeholders, managing multi-million-dollar vendor partnerships, and representing the organization's interests with regulatory and industry partners.
The Provider Network Performance Manager drives provider performance across the New Jersey market by analyzing data to identify improvement opportunities and executing targeted performance plans. This role involves leading provider partnerships, managing joint operating committees, and aligning contracting strategies to meet cost, quality, and access goals.
Provide comprehensive virtual primary care visits, including chronic disease management, preventive screenings, and acute care interventions. Collaborate with a multidisciplinary team to coordinate diagnostics, specialist referrals, and individualized care plans.
Provide holistic clinical care to patients through real-time chat and digital channels while managing concurrent patient conversations. Collaborate with interdisciplinary teams to ensure continuity of care and maintain accurate documentation in the electronic health record.
Provide empathetic clinical care through real-time chat and digital channels while managing patient medical needs and documentation. Collaborate with interdisciplinary teams to ensure continuity of care and facilitate escalations when patient needs exceed digital capabilities.
The Director will own the clinical pharmacy Star Ratings performance strategy, driving outcomes through data-driven insights and cross-functional execution. They will serve as the enterprise subject matter expert, interpreting regulatory changes and leading initiatives to improve medication adherence and clinical quality.
The primary responsibility is the supervision of mid-level providers (APRNs) to satisfy South Carolina state requirements. You will also ensure clinical care is consistent with evidence-based guidelines and participate in biannual meetings.
The primary responsibility is to provide supervision for mid-level providers (APRNs) to meet Georgia state requirements. This includes conducting quarterly meetings and performing monthly chart reviews to ensure clinical care aligns with evidence-based guidelines.
The Care Coordinator supports clinical operations by conducting patient outreach, scheduling follow-up appointments, and managing post-discharge documentation. They also assist with telehealth preparation, coordinate diagnostic testing, and ensure clinical results are reviewed by licensed professionals.
Provide comprehensive virtual primary care, including chronic disease management and acute care interventions via a telehealth platform. Coordinate with multidisciplinary teams for diagnostics and specialist referrals while utilizing electronic health platforms.
Provide virtual primary care visits including chronic disease management, preventive screenings, and acute care interventions via a telehealth platform. Coordinate with multidisciplinary teams for lab work, imaging, and specialist referrals while utilizing an electronic health platform.
Lead a virtual primary care model by managing a patient panel and supervising a team of Advanced Practice Providers. Drive clinical innovation through the development of AI-enabled technology and quality oversight measures.
Perform clinical reviews for Part A, B, appeals, and quality of care while conducting peer-to-peer discussions. Serve as a clinical subject matter expert and participate in acute and post-acute clinical rounds.
The senior manager will lead the development of a new team focused on managing group escalations and centralizing issue intake. They will engage directly with critical provider groups to build trust and resolve issues effectively while driving operational initiatives to improve performance.
