Sr. Manager Provider Operations

Devoted

Northern (KY)

On-site

USD 111,000 - 151,000

Full time

9 days ago

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Benefits offered by this job

Health/dental/vision
Generous PTO
Monthly stipend
Stock options
Bonus eligibility
401K

Job summary

Devoted Health is seeking a Sr. Manager of Provider Operations to own provider data accuracy end to end, from validation to publication in the member-facing directory, and to ensure CMS Medicare Advantage directory compliance.

This role leads a hybrid onshore/offshore team and defines metrics and SLAs to drive improvements and scale operations. You will partner with product, engineering, and network leaders to transform the directory into a proactive care navigation tool while ensuring data

Qualifications

  • Bachelor’s degree and 6+ years of relevant experience, including 2+ years directly managing a team.
  • Healthcare operations experience with provider data, directory or credentialing.
  • Familiar with CMS Medicare Advantage directory rules and audits.
  • Strong data analysis and ability to translate insights into actions.
  • Proven ability to build repeatable processes with QA frameworks.
  • Excellent written and verbal communication for cross-functional collaboration.
  • Excellent organizational skills and deadline focus.

Responsibilities

  • Own provider data accuracy end to end — validation, verification, exception handling, and remediation across roster intake, credentialing, and downstream publication to the member-facing directory.
  • Lead, manage, and grow a hybrid onshore and offshore team — hiring, onboarding, training, quality assurance, capacity planning, and performance management.
  • Define, instrument, and report the metrics and SLAs for provider data accuracy; deliver clear, credible reporting to executive stakeholders.
  • Shape directory strategy — partner with product, engineering, and network leaders to evolve the directory into a care navigation tool.
  • Support care navigation initiatives by ensuring the underlying data that drives steerage decisions is accurate and complete.
  • Partner with product and engineering to automate manual validation work, and evaluate and manage vendor relationships supporting provider data and directory accuracy.

Skills

Provider data management
Regulatory knowledge
Data analysis
Operational excellence
Stakeholder communication

Education

Bachelor’s degree

Tools

SQL
Vendor management

Job description

## Sr. Manager Provider OperationsApplylocations: Remote USAtime type: Full timeposted on: Posted Todayjob requisition id: R3484**Job Description*****A bit about this role:***The Provider Operations team is responsible for delivering tight operations, meaningful data and analytics, user-friendly tools and content, and shared best practices across markets. Foundational to this strategy is our ability to be an engine of accurate provider data, which is inherently complex, messy, and ever-changing. Accurate and accessible provider data allows us to better serve our members and providers, reduces our administrative cost and burden, and keeps us compliant with a growing set of federal and state directory requirements.This role owns provider data and directory accuracy end to end — from the validation and verification work that keeps our records current, to the compliance posture that makes our directory defensible in front of CMS, to the strategic question of how we turn the directory into a tool that actively navigates members to high quality, accessible care. The Sr. Manager will lead a hybrid onshore and offshore team and is expected to grow that team as we scale. We’re looking for a leader who is equally comfortable in a regulation, a data set, and a room full of cross-functional stakeholders.***Your Responsibilities and Impact will include:**** Own provider data accuracy end to end — validation, verification, exception handling, and remediation across roster intake, credentialing, and downstream publication to our member-facing directory* Serve as the accountable owner for provider directory compliance, including CMS Medicare Advantage directory accuracy and verification requirements, online directory obligations. Maintain audit-ready documentation and lead our response to regulatory inquiries and audits* Lead, manage, and grow a hybrid onshore and offshore team — hiring, onboarding, training, quality assurance, capacity planning, and performance management — building the structure and documentation that let the team scale without a linear increase in headcount* Operate and improve our signal-driven accuracy infrastructure, using scoring and prioritized verification queues to focus outreach where the risk to members and to compliance is highest* Define, instrument, and report the metrics and SLAs for provider data accuracy; deliver clear, credible reporting to executive stakeholders and translate results into a prioritized roadmap* Shape directory strategy — partner with product, engineering, and network leaders to evolve the directory from a compliance artifact into a care navigation tool that helps members find high quality, accessible providers* Support care navigation initiatives by ensuring the underlying data that drives steerage decisions is accurate and complete, including specialty, panel status, accepting-new-patient indicators, location, and PCP assignment* Partner with product and engineering to automate manual validation work, and evaluate and manage vendor relationships supporting provider data and directory accuracy***Required skills and experience:**** Bachelor’s degree and a minimum of 6 years of relevant experience, including at least 2 years directly managing a team* Experience at a health plan or in healthcare operations, with hands-on ownership of provider data, provider directory, credentialing, or network operations* Working knowledge of the regulatory environment governing provider directories — CMS Medicare Advantage directory and network adequacy requirements, and comfort reading and operationalizing regulatory guidance* Proficient in analyzing data sets to generate insights and turn those insights into action* Demonstrated success building repeatable operational processes with measurable quality outcomes, including QA frameworks and documented workflows* Strong communication skills to facilitate collaboration and influence stakeholders across compliance, network, product, and engineering* Exceptional organizational skills, adept at prioritizing tasks effectively to consistently meet deadlines***Desired skills and experience:**** Experience managing or scaling offshore and/or vendor delivery teams* Experience applying AI and automation to reduce manual operational work* Experience leading or supporting a regulatory audit or corrective action plan* SQL or equivalent ability to query and validate provider data directly* Thrives in a fast paced, metrics driven environment and is comfortable with ambiguity#LI-Remote Salary Range: **$110,500-$151,00 / year**The pay range listed for this position is the range the organization reasonably and in good faith expects to pay for this position at the time of the posting. 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 will 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.*Founded in 2017, Devoted Health is on a mission to dramatically improve the health and well-being of older Americans by caring for everyone like they are family, and that includes our employees. Our robust and seamlessly integrated care platform merges advanced data and AI access with world-class clinical and service experiences to create a member experience that is unlike the industry norm. To continue building upon our mission, we want to bring together those who share our values, embrace change and advancement, and are enthusiastic about where we're going — all the while bringing their own unique qualities, experiences, and expertise, in hopes of further changing the healthcare experience.
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