Senior Director, Utilization Management

🕒 2 days ago

🏄 California – Remote

🏄 California – Remote

💵 $182k - $278k / year

⏰ Full Time

🟠 Senior

👔 Director

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Devoted Health

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 2017

⚕️ Healthcare Insurance

🧘 Wellness

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

• Process Optimization: Work closely with the UM team leaders and stakeholders across the business to identify and support the execution of process improvements including workflow optimization, medical policy decision support, and technology improvements • Regulatory Translation: Digest regulatory guidance/requirements (e.g., NCDs, LCDs, Medicare Managed Care Manual) and translate them into compliant operational workflows • Influential Leadership: Drive alignment and change across a broad set of cross-functional stakeholders, including Clinical, Product, Engineering, and Network teams, to achieve goals • Stakeholder & Vendor Management: Build credibility and trust with internal teams and external vendors and provider partners • Continuous Improvement: Foster a culture of accountability and transparency, utilizing data-driven insights and AI-enabled tools to continuously refine the medical care journey for our members.

🎯 Requirements

• Bachelor’s degree required; 10+ years of professional experience in healthcare operations or a related field • Integrity & Trust: A strong moral compass and unwavering commitment to caring for members like family • Proven Operator: A track record of transforming complex operational challenges into scalable business processes in a fast-paced environment • Influential Communicator: Excellent written and verbal communication skills with the ability to distill complex problems into actionable updates for leadership and stakeholders • Strategic Leadership: Demonstrated experience leading teams and driving organizational change through relationship building and influence • Regulatory Proficiency: Deeply analytical with the ability to master complex regulatory guidance and incorporate it into daily operations • UM Familiarity: Experience with Utilization Management processes and a solid understanding of the medical necessity review lifecycle.

🏖️ 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; Commission eligibility for Sales roles • Parental leave program • 401K program • And more....