Note: The job is a remote job and is open to candidates in USA. Devoted Health Services, Inc. is hiring a Special Needs Plans (SNP) Operations Manager to oversee regulatory requirements, compliance documentation, and operational due diligence across its SNP programs. The role also improves and standardizes processes and translates changing CMS and Medicaid requirements into effective workflows.

Responsibilities

• Develop Devoted's Models of Care (MOCs) annually in collaboration with the SNP Operations Director
• Oversee and manage Devoted's policies, procedures, and compliance universes in compliance with CMS and Model of Care requirements, ensuring perpetual audit-readiness
• Review new or changing Model of Care and CMS requirements, working cross-functionally to develop and implement operational solutions
• Develop and implement enhanced processes to oversee compliance with Model of Care and CMS-related SNP requirements, including building early warning systems to detect and prevent potential gaps
• Develop Medicaid benefit subject matter expertise, creating knowledge tools and configurations that support frontline staff and members in understanding and coordinating Medicare and Medicaid benefits
• Oversee, with the SNP Operations Director and other SNP Managers, routine Medicaid reporting, and work cross-functionally to develop and submit required Medicaid reports accurately and timely
• Provide additional compliance and operational support across SNP and Medicaid programs as assigned

Skills

• 3+ years of experience in Medicare Advantage, Managed Care, Health Plan, or health care operations
• Proven ability to interpret CMS and/or State Medicaid regulatory guidelines and translate them into standard operational workflows and compliance processes
• Highly detail-oriented, reliable, independent, and curious, with a track record of managing detailed compliance tasks in a fast-paced environment
• Strong communication skills with a demonstrated ability to collaborate with and influence cross-functional teams
• Direct experience with Special Needs Plans (SNPs), SNP Model of Care (MOC) development and implementation, or SNP care management operations
• Experience in the Medicaid space (e.g., Medicaid compliance, benefits administration, claims processing, or D-SNP dual-eligible benefit coordination)

Benefits

• For full-time employees only: employer-sponsored health, dental, and vision plan with low or no premium
• For full-time employees only: generous paid time off
• For full-time employees only: $100 monthly mobile or internet stipend
• For full-time employees only: stock options for all employees
• For full-time employees only: bonus eligibility, excluding Director and above
• For full-time employees only: commission eligibility for Sales roles
• For full-time employees only: parental leave program
• For full-time employees only: 401K program
• Remote (USA) work arrangement

Company Overview