Senior Manager, Provider Escalation, Education

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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

• Ownership of Devoted’s Network Escalations function, including service levels, quality, provider experience, operational performance, compliance, and cost • Leading a team of subject matter experts that resolve network escalations • Running the current machine while designing, implementing, and owning the future-state machine • Defining and executing the roadmap for modernizing through AI, workflow automation, and self-service • Establishing clear visibility into units of work, productivity, quality, cost, and performance metrics • Meet with providers to resolve escalations and deliver proactive performance insights, actively engaging to understand their needs and challenges. • Building and operationalizing AI-enabled and human-in-the-loop workflows that improve quality, consistency, speed, and provider satisfaction • Managing the function through rigorous metrics, KPIs, scorecards, and performance dashboards, with clear accountability for outcomes • Partnering cross-functionally with Network and other health plan operations teams to solve upstream drivers of provider issues and improve end-to-end provider experience • Leading through significant evolution while creating confidence, momentum, stability, and strong culture through change • Raising the talent bar across the organization by setting the pace and modeling high standards.

🎯 Requirements

• At least 5 years of leadership experience with a track record of delivering measurable outcomes in complex operational environments • Outstanding operational rigor with the ability to deploy technology to solve complex business challenges • Proven experience driving end-to-end initiatives from strategy through execution that materially improve quality, service levels, cost, compliance, or operational efficiency • Demonstrated ability to manage through metrics, establish ambitious targets, and drive teams to results with clear accountability • Exceptional attention to detail and precision, with a reputation for sweating the details and getting the hardest operational last mile right • Clear evidence of urgency, resilience, and the ability to move quickly while maintaining high quality standards • Proven ability to leverage complex data sets to inform strategic initiatives and team development, while articulating compelling, data-driven narratives that drive organizational vision and ensure alignment. • Expert at building relationships with a broad range of internal and external stakeholders (provider groups). • Conversational agility expertise demonstrated by the ability to reframe, refocus, and redirect conversations to realize accretive partnerships and desired outcomes. • Additionally, this individual needs to be able to condense complex concepts into simple explanations with clear and concise calls to action.

🏖️ 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....