Devoted Studios

Director, Utilization Management Operations

Remote USA · Director · Full-time

Sponsorship not specified$182k-$248kDetected 20 days ago

Data ScienceVendor ManagementPatient CareLeadershipCommunicationCollaboration

About the role

At Devoted, our mission is to dramatically improve the health and well-being of our members by treating each of them like family.
Core to this mission is ensuring our members receive the right care, at the right time, in the right setting.
We are seeking a leader to serve as the Director of Utilization Management Operations.

Directly lead a team of Senior Managers and Managers who oversee teams of nurses and intake coordinators.
You will also manage our offshore partnership, ensuring their performance metrics and workflows are aligned with department targets.
Partner with Compliance and Legal teams to ensure the operation is consistently audit-ready.
Act as a close partner to the Provider Network team to ensure our operation is responsive to feedback from provider and facility partners.
You will lead a team of clinicians and coordinators, alongside a critical offshore vendor partnership, to ensure our utilization management processes deliver timely and accurate decisions.
Partner closely with Data Science and Engineering teams to identify key measurement points.

A track record of transforming complex operational challenges into scalable business processes in a fast-paced environment.
High ethical standards with the ability to master complex regulatory guidance and incorporate it into daily operations.
Exceptional written and verbal communication skills, with the ability to distill complex problems into actionable updates for leadership.
Familiarity with Medicare Advantage operations and CMS guidelines.
MBA or advanced degree in health administration or finance is a plus.

$182,000 - 248,000 / 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.
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.

You will be responsible for developing, implementing, and systematically monitoring comprehensive KPIs to ensure operational health and decision accuracy.
This individual will be a cornerstone of our Health Services division, bridging the gap between complex clinical needs and scalable, efficient business processes.
You will also partner with Pharmacy UM and the UM Medical Director team to facilitate appropriate service use and minimize care barriers.
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
Our Total Rewards package includes:

This is our work, and we are passionate about it because it matters deeply to our members and provider partners.

This listing is sourced directly from Devoted Studios's careers page and normalized into a canonical job model.