Job Description

A bit about this role:

The Provider Escalation & Education (Prov Esc/Edu) team is dedicated to maintaining strong operational relationships with our Critical Provider Organizations (CPOs) while focused on building partnerships that reduce frustration through efficient issue management and proactive solutions. Our mission is to minimize unnecessary friction and demonstrate true partnership with our provider partners, solidifying Devoted as the health plan of choice and the preferred partner for provider organizations.

We’re looking for an exceptional leader to own and evolve the operational transformation of our Network Escalations (provider escalations via their network team contact) function. AI automation, digital workflows, and self-service are changing the cost and quality curve of operational work, creating a unique opportunity to reimagine Network Escalations as a modern, technology-enabled engine that delivers better provider experience, faster responses to complex problems, upstream issue detection, and stronger quality.

In this role, you’ll lead both the team and the day-to-day operational excellence of our Provider Complex Case Team that handles Network Escalations and the design, implementation, and ownership of its next-generation operating model. We’re looking for a systems-minded operator who can own outcomes end to end — a true builder-operator who can lead a service organization today while designing, implementing, and owning the workflows, systems, and tooling

that will define how the function operates in the future. A key responsibility will be direct engagement with critical provider groups during escalations, including face-to-face meetings to build trust, resolve issues, and reinforce long-term relationships.

Additionally, by driving upstream operational initiatives, the Sr. Manager will identify key pain points and collaborate with cross-functional teams to charter and implement innovative program solutions that mitigate future escalations and improve overall operational performance. This role is pivotal in fostering a culture of proactive problem-solving and continuous improvement within the team.

The best candidate will combine operational excellence, systems thinking, obsession with detail, pace-

setting execution, and the ability to create confidence through change.

This role is ideal for someone who organizes around metrics and outcomes, runs to hard problems, has a strong track record of achieving results, and thrives in ambiguity while building durable systems that outlast any one leader.

Your Responsibilities and Impact will include:

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
Be a Change Maker: This is an opportunity to make a real impact, ensuring our provider partners feel valued and respected while reinforcing our mission to minimize frustration and strengthen relationships.
Foster Strong Provider Relationships: 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

Required skills and experience:

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.

Desired skills and experience:

Experience transforming operations through AI-enabled workflows
Proven ability to thrive in a fast-paced startup environment
Capacity for high throughput, while working both autonomously and collaboratively with others
Track record of success becoming an expert with a tool or system that was unfamiliar to you

#LI-Remote

Salary range: $110,500 - $150,000 /year

The pay range listed for this position is the range the organization reasonably and in good faith expects to pay for this position at the time of the posting. 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 will 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.

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!

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.

Senior Manager, Provider Escalation and Education