Remote Claims Compliance Program Lead

Devoted Health; United States; Remote; USD 73,000 - 130,000; Full time

Benefits offered by this job

Health plan

Dental and vision plan

Paid time off

Mobile stipend

Stock options

Bonus eligibility

Parental leave

401K

Job summary

Devoted Health is seeking a Claims Compliance Program Manager to oversee compliance activities, KPIs, and audit readiness across Medicare Advantage and Medicaid claims operations. You will collaborate with Claims, Payment Integrity, and Compliance teams to address gaps and strengthen internal controls.

Responsibilities include documenting audits, tracking issues in Jira, and developing policies and SOPs. A background in healthcare or tech operations and strong communication are essential for

Qualifications

• Proven ability to manage multiple priorities and support operational monitoring activities.
• Strong interpersonal and verbal communication skills to collaborate across teams on audit and compliance findings.
• Proficient in drafting clear, precise compliance reports, summaries and official audit documentation.
• Experience in developing, updating, and standardizing SOPs, policies and workflow documentation.
• Bachelor's degree required or equivalent work experience.

Responsibilities

• Monitor claims compliance activities, KPIs, and reports to identify trends, risks, gaps, and improvements.
• Coordinate and document internal, financial, and regulatory audits.
• Analyze claims data to identify discrepancies and recurring issues.
• Track compliance issues, deliverables, Jira tasks, and audit findings, collaborating to ensure remediation.
• Support QA operations, including audit workflows, operational reporting, and data validation.

Skills

Organization

Communication

Writing

Process documentation

Education

Bachelor's degree or equivalent

Job description

Devoted Health is seeking a Claims Compliance Program Manager to oversee compliance activities, KPIs, and audit readiness across Medicare Advantage and Medicaid claims operations. You will collaborate with Claims, Payment Integrity, and Compliance teams to address gaps and strengthen internal controls.

Responsibilities include documenting audits, tracking issues in Jira, and developing policies and SOPs. A background in healthcare or tech operations and strong communication are essential for