Devoted Health
Director, Risk Adjustment Provider Program
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 partner with people we love for a cause we believe in. Life is short. Join us."
A bit about this role:
Devoted Health’s Risk Adjustment team is entrusted with securing and submitting the revenue of our plan in order to fund the care that we provide to our members. Our work directly enables better care and better benefits for our members, and our team is an exemplar of hyper-compliance with our regulators. Our team includes three functions that collectively work to ensure the complete and accurate submission of diagnosis data to CMS:
- Risk Adjustment Provider Program: supports our provider partners with the data, education, and infrastructure needed to accurately and completely document our members’ true conditions at the point of care
- Risk Adjustment Retrospective Program: retrieves and reviews medical documentation for historical dates of service to ensure the accurate and complete documentation of our members’ true conditions after the point of care
- Risk Adjustment Program Integrity: ensures the integrity of our risk adjustment programs through the complete and timely submission of data to CMS and through a highly active auditing program
In this role you will be responsible for leading one of these three verticals -- our Risk Adjustment Provider Program. You will develop and lead a national risk adjustment program that builds credibility and trust with our provider partners, supports our providers in their effort to see, diagnose, treat, and document our members, and is a paragon of hypercompliance. You will work directly with providers as an expert on risk adjustment programs. You will partner with our network teams to develop and deploy an evidence-based risk adjustment provider program. You will lead a team and manage vendors. You will measure and learn from our engagements, developing insights that shape our approach.
Responsibilities will include:
- Crystallize our risk adjustment provider program into a scalable, professional offering that can be deployed nationally and that delivers results
- Be the face of risk adjustment to our providers, building credibility and trust
- Lead a team and manage vendors
- Apply deeply analytical and rigorous measurement to inform a pragmatic, effective program strategy
- Partner with our Network teams to understand and work within the multi-faceted relationships we have with our provider partners
Key attributes:
- A risk adjustment expert (or an extremely quick study) whose primary super power is working with providers or clients to build credibility and achieve results
- A natural relationship builder
- A true operator with an ability to understand complexity and turn it into business processes
- Results-oriented: you are energized by having an ambitious goal and the latitude to execute against it
- Strong people management and vendor management skills
- Deeply strategic, analytical and technically proficient
- Pragmatic with a bias towards producing highly practical, highly scalable solutions
- Ability to deal effectively with ambiguity
- Can-do attitude and stamina for tackling hard problems
- Strong moral compass and unwavering commitment to caring for members like family
- through hypercompliance
Desired skills and experience:
- 10+ years of experience, MBA preferred but not required
- Risk Adjustment & Medicare Advantage expertise
- Track record of success in client-facing roles
- Proven leader; people follow you
- Self-starter and team player who can build relationships with a wide range of partners and approaches challenges with a can-do attitude; you’re self-reflective.
If you love running towards complex challenges and transforming them into solutions, if you want to make a potentially huge impact on many lives, and if you are looking for a disruptive startup with an inspiring and talented team, Devoted Health may be the place for you!
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.
We want to make your healthcare easier, more affordable, and a whole lot more caring. And we've got the Medicare Advantage plans to make it happen.
- Founded
- Founded 2017
- Employees
- 500+ employees
- Industry
- Health Care Providers & Services
- Total raised
- $360M raised