Claims Compliance Program Manager

🔥 1 minute ago

🇺🇸 United States – Remote

💵 $73k - $130k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

📋 Program Manager

👻 Ghost score 0%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

Apply Now

Find Similar Remote Jobs

Set Up Email Alert For New Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

Devoted Health

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 2017

🏥 Healthcare

⚕️ Healthcare Insurance

🧘 Wellness

Healthcare • Healthcare Insurance • Wellness

Devoted Health is a healthcare company that offers Medicare Advantage plans designed to provide comprehensive health coverage with added benefits like dental, eyewear, gym memberships, and prescription drugs at competitive rates. The company emphasizes member support and service, ensuring that clients can easily navigate their benefits and access needed healthcare services. Devoted Health is committed to helping customers save money and enhance their health and wellness through a complete package of benefits and support.

📋 Description

• Monitor claims compliance activities, KPIs, and reports to identify trends, risks, operational gaps, and areas for improvement • 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 cross-functionally to ensure timely remediation • Support quality assurance operations, including audit workflows, operational reporting, and data validation • Develop and update policies, procedures, and related compliance materials • Escalate compliance concerns and control deficiencies to management • Participate in risk assessments to strengthen internal controls • Collaborate across Claims, Payment Integrity, and Compliance teams to investigate issues • Evaluate workflow gaps and recommend practical solutions to mitigate risks • Support the implementation and oversight of corrective action plans • Identify opportunities to improve the efficiency, accuracy, and consistency of assigned compliance activities • Assist with AI initiatives and automation projects in claims compliance operations

🎯 Requirements

• Proven ability to manage multiple priorities, support operational monitoring activities, and ensure timely tracking of compliance deliverables and issue resolution • Strong interpersonal and verbal communication skills to effectively collaborate across teams and engage with cross-functional stakeholders on audit and compliance findings • Proficient in drafting clear, precise, and structured compliance reports, summaries, and official audit documentation • Experience in developing, updating, and standardizing standard operating procedures (SOPs), policies, and workflow documentation • Bachelor's degree required, or equivalent work experience • Experience in healthcare, healthcare technology, or tech operations, preferred • Experience with healthcare operations, claims adjudication, or regulatory compliance requirements, preferred • Proven ability to thrive in a fast-paced startup environment • Capacity for high throughput, while working both autonomously and collaboratively with others • Track record of success becoming an expert with a tool or system that was unfamiliar to you • Comfort using data and reporting platforms to drive operational insights and track performance

🏖️ Benefits

• 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 • Parental leave program • 401K program