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 about this role:
The Senior Manager of Medical Economics/Medical Expense Actuary will play a key role in supporting the organization’s efforts to improve medical costs. This individual will collaborate with cross-functional teams to identify opportunities for cost optimization while maintaining high standards of quality and patient care. Working closely with various business areas (e.g., market leadership, payment integrity and claims, network, engineering, Devoted Medical), the actuarial team, and executive leadership, the Manager will contribute to key operational and strategic decisions. This role requires a strong foundation in healthcare economics, data analysis, and strategic planning, along with a solid understanding of healthcare delivery systems and reimbursement models. We’re looking for someone with intellectual curiosity and a passion for driving results.

Your Responsibilities and impact will include:

• Medical Cost Analysis and Support: Support the identification, quantification, and tracking of activities related to medical expenses. This includes decomposing financial performance as it emerges and ensuring timely and accurate claims payments through collaboration with the Claims team.
• Provider Reimbursement Strategy: Partner with the network team to understand and quantify reimbursement terms and provide consultation and advice on provider and facility reimbursement strategies.
• Data-Driven Insights: Conduct in-depth analyses of healthcare utilization patterns, cost drivers, and performance metrics to identify areas for improvement and cost savings opportunities. This involves interpreting and analyzing clinical data from various sources to summarize observations and recommend actionable responses.
• Cross-Functional Collaboration: Partner closely with internal stakeholders, including clinical leadership, actuarial, accounting, finance operations, operations, network management, and local market teams, to support the development, execution, tracking, and management of strategies aligned with organizational goals. This includes providing expertise and consultation to advance capabilities in provider contracting, clinical program assessment, population health, payment integrity, provider reimbursement, and financial performance management.
• Financial Impact Assessment: Utilize analytical techniques, in collaboration with the finance, network, and/or data science teams, to forecast and evaluate the financial impact of proposed initiatives and interventions.
• Performance Monitoring: Monitor and evaluate the effectiveness of implemented initiatives through ongoing performance tracking and analysis, making data-driven recommendations for adjustments and improvements as needed.
• Industry Expertise: Stay informed about industry trends, regulatory changes, and best practices in healthcare economics and medical cost management, incorporating relevant insights into planning and decision-making, and seeking opportunities to translate those to Devoted Health.
• Reporting and Presentations: Prepare and present regular reports and presentations to leadership on the status of cost improvement initiatives, key performance indicators, and financial outcomes.
• Adherence to Core Values: Operate in accordance with Devoted’s core values: Treat every member like family, Build for a rolling 20-year time horizon, Operate as a paragon of hypercompliance.

Required Skills and Experience:

• 5+ years of relevant experience in healthcare, with a strong focus on Government Programs, specifically Medicare Advantage, including expertise in provider reimbursement and medical economics.
• Solid functional expertise with an understanding of the key financial drivers of Medicare Advantage health plan operations.
• Highly analytical and hands-on, with the ability to be a contributor from day one and translate data into actionable insights.
• Strong communication and interpersonal skills, capable of engaging and collaborating with diverse stakeholders.
• Strategic ability to understand the business at large and connect mathematical and financial relationships across the organization.
• Comfortable operating in a dynamic, fast-paced, and ambiguous startup environment where we continuously develop and optimize our operations.
• Ability to effectively present areas of opportunity to all areas of the organization, including operations, clinical, and finance.
• Unwavering commitment to the highest ethical standards at all times, including maintaining the confidentiality of financial and other sensitive information consistent with moral, professional, and regulatory requirements.

Desired Skills and Experience:

• Actuarial credential (ASA or FSA) is a plus.
• Broad understanding of managed care business and financial principles such as underwriting, risk adjustment, medical management, physician reimbursement, and risk management.
• Experience extracting and analyzing healthcare claims data directly; experience working with programming languages such as SQL, R, and/or Python is a plus.

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Salary Range: Commensurate with experience
Our ranges are purposefully broad to allow for growth within the role over time. 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 may 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.
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 have been made aware of instances of fraudulent job postings and/or fraudulent recruiting activity by individuals purporting to represent Devoted Health. These fraudulent schemes often seek monetary contributions or payments from job seekers (such as for “start up costs” or “equipment”), or seek to collect sensitive personal information. These job postings and offers are NOT authorized by Devoted Health and Devoted is not responsible for fraudulent offers, personal information that you may have disclosed, or payments made to third parties purporting to represent Devoted. We have reported this matter and are cooperating with law enforcement agencies. Devoted Health will never ask for financial commitment or contribution from a candidate at any stage of the recruitment process.

• Medical Cost Analysis and Support: Support the identification, quantification, and tracking of activities related to medical expenses. This includes decomposing financial performance as it emerges and ensuring timely and accurate claims payments through collaboration with the Claims team.
• Provider Reimbursement Strategy: Partner with the network team to understand and quantify reimbursement terms and provide consultation and advice on provider and facility reimbursement strategies.
• Data-Driven Insights: Conduct in-depth analyses of healthcare utilization patterns, cost drivers, and performance metrics to identify areas for improvement and cost savings opportunities. This involves interpreting and analyzing clinical data from various sources to summarize observations and recommend actionable responses.
• Cross-Functional Collaboration: Partner closely with internal stakeholders, including clinical leadership, actuarial, accounting, finance operations, operations, network management, and local market teams, to support the development, execution, tracking, and management of strategies aligned with organizational goals. This includes providing expertise and consultation to advance capabilities in provider contracting, clinical program assessment, population health, payment integrity, provider reimbursement, and financial performance management.
• Financial Impact Assessment: Utilize analytical techniques, in collaboration with the finance, network, and/or data science teams, to forecast and evaluate the financial impact of proposed initiatives and interventions.
• Performance Monitoring: Monitor and evaluate the effectiveness of implemented initiatives through ongoing performance tracking and analysis, making data-driven recommendations for adjustments and improvements as needed.
• Industry Expertise: Stay informed about industry trends, regulatory changes, and best practices in healthcare economics and medical cost management, incorporating relevant insights into planning and decision-making, and seeking opportunities to translate those to Devoted Health.
• Reporting and Presentations: Prepare and present regular reports and presentations to leadership on the status of cost improvement initiatives, key performance indicators, and financial outcomes.
• Adherence to Core Values: Operate in accordance with Devoted’s core values: Treat every member like family, Build for a rolling 20-year time horizon, Operate as a paragon of hypercompliance