Jobs at Devoted Health

Lead end-to-end provider data and directory accuracy, ensuring compliance with CMS Medicare Advantage requirements. Manage and scale a hybrid onshore/offshore team, implement signal-driven verification workflows, define SLAs and reporting, partner with product and engineering to automate validation, and support care navigation initiatives through accurate provider metadata and vendor management.

Leads end-to-end change readiness for Guide-facing operational transformations, including deployment, adoption, feedback, milestone readiness, training, communications, and post-launch monitoring. Builds repeatable tooling such as playbooks, readiness trackers, dashboards, and change calendars. Partners with Product and Technology to shape releases, pilots, and launch criteria while managing cross-team dependencies and downstream impacts on staffing, quality, scorecards, and training. Uses AI to synthesize feedback and develop communications, training, and lightweight tools.

Provides direct patient care through pharmacist consultations, chronic disease education, medication therapy management, drug therapy issue resolution, and pharmacy quality programs. Collaborates with providers and interdisciplinary teams, supports benefits navigation, participates in on-call rotations, mentors team members, contributes to pharmacy model development, and uses AI-enabled clinical tools. Requires fluent Spanish, multi-state pharmacist licensure, and at least three years of clinical experience.

Provides pharmacist-led care through chronic disease management, medication therapy management, patient education, therapy-gap resolution, and pharmacy quality programs. Conducts medication reviews, identifies drug therapy issues, collaborates with providers and interdisciplinary teams, supports benefit navigation, mentors staff, participates in on-call rotations, and helps develop pharmacy practices. Requires multilingual Cantonese/Mandarin proficiency, multistate licensure, and support for Pacific or Central clinic hours.

Provides pharmacist-led clinical care through chronic disease management, medication therapy management, patient education, therapy-gap resolution, and pharmacy quality programs. Collaborates with patients, providers, and interdisciplinary teams; supports benefits navigation, practice operations, urgent on-call needs, team mentoring, and AI-enabled documentation and drug therapy identification. Requires multilingual Cantonese/Mandarin fluency, direct patient-care experience, and licensure across multiple states.

Provides pharmacist-led chronic disease management, medication therapy management, patient education, and drug therapy optimization. Conducts comprehensive medication reviews, resolves therapy issues, addresses quality-care gaps, and collaborates with patients, providers, and interdisciplinary teams. Supports pharmacy practice operations, urgent on-call needs, clinical model development, staff mentoring, AI-enabled documentation tools, and obtaining additional state licenses.

Lead and execute end-to-end provider network contracting across Commercial and Medicare Advantage lines. Close complex negotiations with physician groups and ancillary providers, optimize fee schedules and pricing, and operationalize agreements with Provider Ops, Claims, and Credentialing. Build and mentor a high-performing contracting team, standardize playbooks, and leverage AI-assisted tools and data visualization to accelerate deal execution and reporting. Collaborate cross-functionally with Actuarial, Underwriting, Product, and Sales to support market expansion and competitive pricing.

Lead cross-functional initiatives for agency onboarding, compliance analysis, and partnership enhancements. Scope, plan, and drive projects to implementation using JIRA and Looker, design scalable processes, manage risks and reporting, and support relationship management for top agency partners while ensuring compliance and operational efficiency.

Design and manage the full lifecycle of payment integrity edits and audits, converting CMS, AMA/CPT, and coding regulations into rule logic. Validate hypotheses using data queries, author technical specifications, optimize post-release performance, adopt LLM/AI workflows, map regulatory policy, and coordinate cross-functionally to ensure defensible, efficient claims processing.

Lead clinical pharmacy strategy and execution for Medicare Advantage and Part D Stars measures. Own performance forecasting, measure readiness, regulatory interpretation, cross-functional vendor collaboration (including PBM), and implementation of interventions to drive 5-Star outcomes. Build trackers, set OKRs, audit outreach effectiveness, and represent pharmacy quality in executive forums.

The Senior Manager, AI Performance & Operations is responsible for the performance and improvement of AI workflows, incident response, designing evaluation systems, and stakeholder communication.

Provide telephonic and virtual social work case management for high‑needs patients: assess social determinants, develop personalized care plans, coordinate community and clinical resources, support caregivers, facilitate advanced care and palliative/hospice planning, and collaborate with an interdisciplinary team to improve outcomes.