Devoted Health
Claims Configuration Senior Manager
$110K–$150K
Remote USA · Manager · Full-time · Posted Oct 26, 2026
- Experience
- 6+ years in business operations or operational leadership.
About the job
Owns the accuracy and strategy of claims adjudication logic, provider-contract matching, payment communications, and remittance outputs, while improving automation and operational performance.
What you'll do
- Optimize auto-adjudication rules and manual-review flags in partnership with Engineering.
- Own provider-contract matching and EOB/EOP and remittance logic; investigate errors and drive root-cause fixes.
- Build audits, validation tests, KPIs, and reporting to measure claims logic accuracy and performance.
What they ask for
- 6+ years of experience in business operations or operational leadership.
- Strong analytical skills, including building KPIs and using large claims datasets to diagnose outcomes and quantify impact.
- Demonstrated success driving measurable operational change and continuous improvement in fast-paced environments.
- Strong communication skills and ability to explain complex claims logic to technical and non-technical audiences.
Nice to have
- Hands-on experience with AI tools, automation, or LLM-based workflows in operations.
- Knowledge of health insurance claims processing, particularly Medicare Advantage, or experience partnering with Engineering on rules-based systems, workflow design, or claims platform development.
Pay
$110,500 - $150,000 annually (base salary)
Tools
AI tools, LLM-based workflows, 835/ERA
AI focus
Desired experience includes using AI tools, automation, or LLM-based workflows in operational settings; the role also evaluates emerging technology for claims-operation improvements.
Model-written summary · the original posting is authoritative