Job description
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 more about this role:
The Membership Operations Associate works collaboratively with the team to execute the day-to-day business processes required to support the delivery of critical health services: enrollment, membership maintenance, 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 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: Marketing, Agent Support, Telesales, Guides, Claims, Provider, Pharmacy, Risk Adjustment and Finance.
Responsibilities will include:
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Ensure the integrity of membership data.
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Maintain an established working knowledge of applicable federal and state laws, regulations, CMS policy guidance and contract standards.
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Research and interpret errors identified to ensure accurate membership data and payments.
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Present and articulate data/findings/opportunities to internal and external partners.
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Oversee internal and external audits, including but not limited to: research, case creation, submission and corrective action implementation.
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Integrate process improvements through reconciliation and monitoring, to ensure membership, enrollment and payment data is accurate and in alignment with federal and state reporting.
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Provide accurate and thorough written responses to inquiries.
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Relate openly and comfortably with a diverse group of people as a representative of the Membership Operations team.
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Support offshore operations for duties performed on behalf of the functional team, areas of responsibility, but not limited to: training, documentation, meetings, quality assurance of a FDR.
Attributes of Success:
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Reacts tactfully when giving, receiving advice, instruction, or critical feedback.
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Comprehensive root-cause analytic skills and a knack for tearing apart problems
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Highly organized
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Enthusiastic about helping others, meeting challenges and effectively participating in group settings
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Team player attitude with the willingness to take initiatives to troubleshoot Compliance-driven; works well in a fast-paced environment with firm deliverables and timeframes
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Quick learner and adaptable to change in a fast-paced, rapidly changing environment
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Curiosity to recognize process deficiencies, recommend improvements and implement solutions.
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Flexibility and willingness to change according to business needs
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Comfortable working both individually and team settings
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Enthusiastic about helping others, meeting challenges and effectively participating in group settings
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Compassion for healthcare challenges facing the Medicare population
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Ability to accommodate overtime and/or a rotating schedule in accordance with work volume demands.
Desired Skills and Experience:
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Ability to work in a startup, fast paced environment
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3+ years experience in healthcare, ideally Medicare Advantage operations experience
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Experience with Medicare (Part C & D) standards required as well as knowledge of Medicaid and state requirements
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Self-motivated with desire and flexibility to collaborate with co-workers in a virtual environment as a team player
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Entrepreneurial, proactive, and flexible individual comfortable in a high growth environment with an ability to proactively work across an organization.
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Ability to continue to learn and stay current on Medicare initiatives in the marketplace
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Proficient in spreadsheets; ability to navigate the Google Suites platforms
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. If you lack a specific credential for this position but believe that your strengths and life experiences will propel our mission, we would love to hear from you.
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!
#LI-Remote
Salary Range: $28.98-$32.08 per hour
Our Total Rewards package includes:
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Employer sponsored health, dental and vision plan with low or no premium
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Generous paid time off
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$100 monthly mobile or internet stipend
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Stock options for all employees
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Bonus or commission eligibility for all roles
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Parental leave program
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401K program
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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.
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