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:

Devoted Health’s Membership Operations team is entrusted with R&D and operational execution to deliver on that aspiration. This team includes functions that collectively work to ensure the integrity of our member’s data required for navigating health plan operations:

• SNP: dedicated to validating eligibility and analyzing Devoted membership and payment data against State Medicaid reporting to ensure alignment.

• Enrollment: responsible for the transition of a Medicare beneficiary applicant to a member into our Devoted family of Medicare Advantage plans ensuring a warm hand-off from Sales.

• Member Data Integrity: analyze daily response reports from CMS to ensure accurate and timely distribution of member data to internal and external partners and materials to our members

• Member Financial Integrity: assess low income subsidy and late enrollment penalty, process plan premiums and analyze other health insurance to ensure member financial data is accurate and timely.

• Member and Payment Reconciliation: analyze Devoted membership and payment data against the Center of Medicare and Medicaid Services monthly reporting to ensure alignment.

The Membership Operations Senior Associate is responsible for escalated or more complex work within a designated function. In this role, you will address problems by drawing on standard procedures and professional experience, while leveraging resources to gain input. You will take initiative to organize work effectively, critically assess information, inform key stakeholders of work status and issues and know who and when to escalate problems.

The Membership Operations Senior Associate works collaboratively with team leadership to plan, implement and support the execution of processes required for the delivery of critical health services: enrollment, membership, and financial transactions impacting Devoted Health members. In this role, you will demonstrate compliance with the Center for Medicare and Medicaid Services guidance, state Medicaid regulations, Devoted Health policy and Membership Operations procedures/protocols.

As Membership Operations Senior Associate, you will collaborate with designated staff from Devoted Product, Engineering, Data Science and Integration teams to develop and enhance solutions to improve processes. As well, you will directly support our internal partners: Compliance, Marketing, Agent Support, Telesales, Guides, Claims, Provider, Pharmacy, Risk Adjustment and Finance.

The successful candidate will comprehend, articulate and deliver on operational decisions made, and exercise individual discretion in matters of importance.

Your responsibilities and impact will include:

An established confidence in knowledge of applicable federal and state laws, regulations, CMS policy guidance and contract standards and conducts business specific analysis, prepares and communicates business impacts summarizing requirements and recommended actions.

• Reliably delivers work/projects to meet defined objectives.

• Monitor and analyze non-compliant trends and collaborate with key stakeholders to correct gaps

• Maintain operational standards of excellence while preparing for annual readiness

• Support the scalability of offshore operations for duties performed on behalf of the functional team.

• Relate openly and comfortably with a diverse group of people as a representative of the Membership Operations team.

Required skills and experience:

• Strong attention to detail, organized and thorough with a desire for continuous process improvements

• Ability to balance multiple initiatives and prioritize workload, adapt to change quickly and strong ability to problem solve

• Strong organizational, interpersonal, communication and presentation skills

• High level of self-motivation; ability to accomplish goals independently

• Passion towards process improvement and efficiency, and have an ability to predict and prevent bottlenecks

• Strong communicator with cross-functional stakeholders to drive alignment

• A creative thinker with a can-do attitude with the stamina to tackling hard problems

• Experience with Medicare (Part C & D) standards required as well as knowledge of Medicaid and state requirements

Desired skills and experience:

• Ability to work in a fast-paced, startup environment

• 5+ years' experience with a proven track record in Medicare Advantage, and/or a proven track record with complex business analytics.

• Self-motivated with desire and flexibility to collaborate with co-workers in a virtual environment as a team player

• Entrepreneurial, proactive, and flexible individual comfortable in a high growth environment with an ability to proactively work across an organization.

• Ability to continue to learn and stay current on Medicare initiatives in the marketplace

• Ability to travel from time-to-time
  
  

Salary Range: $54,000 - $77,000 / 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.