Claims & Payments Director

Claims & Payments Director Sme

We're seeking a Claims & Payments Director Sme to serve as a critical individual contributor and our lead expert on all claims-related policy matters. This role is a unique blend of deep, hands-on claims analysis and strategic payment policy leadership. You will be the primary point of contact for complex claims issues, using your expertise to influence providers, lead key committees, and ensure our policies are compliant, fair, and operationally sound. This is not a management role, but it requires significant leadership and influencing skills to drive impact across the organization. You'll be expected to work with a high degree of autonomy, serving as a trusted advisor to national health systems and internal teams including executive leadership.

Your responsibilities and impact will include :

• Interface directly with providers, particularly health systems, on claims policies and claims disputes.
• Lead our Payment Policy Committee (Ppc) and serve as our lead expert on claims and payment regulations.
• Serve on our Contract Committee and review all provider contracts brought to the committee, flagging any non-favorable, vague, non-compliant, or operationally unfeasible payment terms.
• Review complex claims, making clear and reasonable adjudication decisions while also setting policy and precedence for other similar claims.

Required skills and experience :

Salary range : $225,000 - $300,000 / year

Our total rewards package includes :

Our total rewards package is for full time employees only. Intern and contract positions are not eligible.

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.