A bit about us:

We’re on a mission to change healthcare — how it’s paid for, delivered, experienced. We want to put people center stage, not process or profit. We are guided by a deep belief that every person on Medicare should be treated like we would treat a member of our own family: with loving care and a profound commitment to their health and well-being. That’s why we’re gathering a whole bunch of smart, big-hearted people to create a new kind of healthcare company — one that combines compassion, health insurance, clinical care, and technology seamlessly.

We want to throw the long ball with people we love for a cause we believe in. Life is short. Join us.

A day in the life may include:

This role will be instrumental in analyzing provider demographic information, quality reports, and special project data. The ideal candidate will assist the network team in preparing for periodic provider meetings. The ideal candidate will also have knowledge of provider contracts, claims payments, provider set up, and root cause analysis. A key to success will be someone who has exhibited a proven ability to work independently, while still working with a team, exhibits strong organizational skills and is goal oriented.

Responsibilities:

• Auditing functions: provider set up in Orinoco (demographic and fee schedules), online search tool, print directory, Periscope reports, claims payment. Determine root cause of issues and recommend process improvements. Provide clear analysis and next steps for network team
• Analysis of network grievances, determination of track and trend or provider outreach, complete outreach as needed, prepare monthly reporting
• Contracting to support network adequacy and marketability in existing and expansion counties. Contract processing, to include: obtaining contract signatures, preparing provider rosters, submitting contract intake form
• Virtual and in-person meetings with provider educating providers about Devoted products, processes and procedures, create provider awareness, and address provider issues
• Assistance with Field Network cases, outreach to providers, documentation of resolution
• Evaluate participation requests against network needs, current contractual relationships, expansion efforts, access to care. Make recommendations to management. Contract as needed. Respond accordingly to providers
• Assist network managers with monthly JOC meeting preparations, , audit provider reports for accuracy, assist with follow up items from meetings

Attributes to success:

• You have the desire to assist network operations in providing excellent service to our providers
• You are excited by the fast pace of the organization and accept opportunities for change
• You are willing to share your experiences to create best practices
• You are skilled at data evaluation, root cause identification, and synopsis

Desired skills and experience:

• Ability to navigate Google or MS Suite of products
• 4+ years healthcare experience with a Medicare Advantage organization preferred
• Proven track record of detail oriented work
• Experience in claims research, provider set up, root cause analysis, process improvement
• 3 + years of direct provider interaction preferred

Salary range: $60,000 to $75,000

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 or commission eligibility for all 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.

The salary and/or hourly range listed is a good faith determination of potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement and may be modified in the future. When determining a team member's base salary and/or rate, several factors may be considered as applicable (e.g., location, specialty, years of relevant experience, education, credentials, budget and internal equity).

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.

Looking for more jobs near me. Find your favorite job now by visiting our jobs page.