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Responsibilities:
- Manage the full lifecycle of edit and audit development from initial hypothesis to detailed rule design.
- Design defensible payment policies and anticipate downstream appeal behaviors.
- Optimize concept efficacy post-release through continuous refinement.
Requirements:
- Bachelor's degree and 4+ years in health plan or payment integrity environment.
- Proven expertise as a coding and billing regulations expert with CMS policy familiarity.
- Demonstrated ability to write logic rules for claims processing.
Our Culture:
- We are on a mission to dramatically improve health care for older Americans.
- We value diversity, collaboration, and treat our members like family.
Devoted Health
Devoted Health is an all-in-one healthcare company combining health insurance, clinical care, service, and technology to improve the health and well-being of older Americans. Founded in 2017, we've grown fast and now serve members across the United States, with a diverse and big-hearted team.