Health Plan Operations Leader – Payment Integrity & AI

Devoted Health; Oregon; Hybrid; USD 111,000 - 150,000; Full time

Benefits offered by this job

Health insurance

Generous paid time off

$100 monthly mobile stipend

Stock options

Job summary

Devoted Health is seeking an experienced Business Operations Senior Manager to lead its Payment Integrity operations. You will manage daily performance, backlogs, and queue health while partnering with Engineering, Claims, and Network teams to drive end-to-end improvements.

The role emphasizes measurable results, process design, and scalable workflows. You will also drive AI-assisted automation and address blockers to ensure smooth operations and high-quality outcomes for members and providers.

Qualifications

• 6+ years of experience in business operations or operational leadership.
• Proven ability to drive meaningful change and measurable operational results in fast-paced environments.
• Analytic mindset with ability to perform qualitative and quantitative analyses.

Responsibilities

• Own the daily health of the operation, monitor TAT, clear backlogs, and maintain queue health.
• Oversee performance and maintain alignment between productivity and audit accuracy.
• Design, test, and launch scalable cross-functional workflows with change management and KPI tracking.
• Partner with external vendors and cross-functional teams to align on priorities and streamline workflows.
• Identify opportunities to reduce manual effort by deploying AI agents with human staff.
• Serve as escalation point to resolve blockers and ensure training and job aids are available.

Skills

Operational leadership

Process improvement

Analytical mindset

Cross-functional collaboration

Communication

Organizational skills

Problem-solving

Ambiguity tolerance

Job description

Devoted Health is seeking an experienced Business Operations Senior Manager to lead its Payment Integrity operations. You will manage daily performance, backlogs, and queue health while partnering with Engineering, Claims, and Network teams to drive end-to-end improvements.

The role emphasizes measurable results, process design, and scalable workflows. You will also drive AI-assisted automation and address blockers to ensure smooth operations and high-quality outcomes for members and providers.