Director, Payment Integrity Program Development

At Devoted Health, we’re on a mission to dramatically improve the health and well-being of older Americans by caring for every person like family. That’s why we’re gathering smart, diverse, and big-hearted people to create a new kind of all-in-one healthcare company — one that combines compassion, health insurance, clinical care, service, and technology - to deliver a complete and integrated healthcare solution that delivers high quality care that everyone would want for someone they love. Founded in 2017, we've grown fast and now serve members across the United States.  And we've just started. So join us on this mission!

Job Description

A bit about this role : 

At Devoted Health, we’re on a mission to dramatically improve the health and well-being of older Americans by caring for every person like family. Our Payment Integrity Department builds trust with our providers and members by ensuring claims are paid accurately and on time with transparent policies.

As a Payment Integrity Program Development Director, you will be accountable for identifying and researching new medical cost savings opportunities. This is a strategic role for a hands-on operator who can develop short and long-term solutions and organize stakeholders to make critical "buy vs. build" decisions. You will use your subject matter expertise in healthcare, evaluate policies, analyze claims data, and collaborate with experts and senior leaders across the company.

Your Responsibilities and Impact will include:

• Lead critical payment integrity initiatives spanning multiple operational teams, ensuring cross-functional alignment, on-time delivery, and measurable business impact.

• Partner with technology teams to define and implement tools that enhance data analysis, streamline workflows, and accelerate payment integrity concept development.

• Develop the strategic vision for new payment integrity programs, aligning with organizational goals and Medicare Advantage regulatory requirements.

• Generate ideas and design innovative concepts to address claim payment leakage, fraud, waste, and abuse.

• Monitor changes in Medicare Advantage policies and implement necessary adjustments to payment integrity processes.

• Foster collaboration with cross-functional teams, including Claims, Compliance, Clinical Operations, and Finance, to identify and prioritize new initiatives.

• Establish and monitor key performance indicators (KPIs) to measure the success of new programs.

Required skills and experience:

• Bachelor's degree and a minimum of 10 years of relevant professional experience.

• A strong understanding of U.S. healthcare, claims adjudication, revenue cycle management, and payment integrity.

• A proven track record of using data to inform ideation and strategy for medical cost savings.

• Exceptional leadership and execution skills, with the ability to drive complex projects and navigate an ambiguous, fast-paced, startup environment.

• Comfortable operating in both leadership and execution roles.

Desired skills and experience:

• Proficiency with SQL or other data querying tools.

• People management or team leadership experience.

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Salary Range: $155,000 - $230,000 / year

Our ranges are purposefully broad to allow for growth within the role over time. 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 may 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.

Healthcare equality is at the center of Devoted’s mission to treat our members like family.  We are committed to a diverse and vibrant workforce. 

Devoted is an equal opportunity employer. We are committed to a safe and supportive work environment in which all employees have the opportunity to participate and contribute to the success of the business. We value diversity and collaboration. Individuals are respected for their skills, experience, and unique perspectives. This commitment is embodied in Devoted’s Code of Conduct, our company values and the way we do business.

As an Equal Opportunity Employer, the Company does not discriminate on the basis of race, color, religion, sex, pregnancy status, marital status, national origin, disability, age, sexual orientation, veteran status, genetic information, gender identity, gender expression, or any other factor prohibited by law. Our management team is dedicated to this policy with respect to recruitment, hiring, placement, promotion, transfer, training, compensation, benefits, employee activities and general treatment during employment.