<p style="text-align:left"><u><b>Job Description</b></u></p><p><b><b>This role is fully remote and must be located within the 50 U.S. states. Standard working hours are in Eastern Timezone. Semi-annual travel may be required to a Devoted office for on-site work.</b></b></p><h3><i>A bit about this role: </i></h3><p>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. This is our work, and we are passionate about it because it matters deeply to our members and provider partners.</p><p>We are seeking a leader to serve as the Director of Utilization Management Operations. 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 lead a team of clinicians and coordinators, alongside a critical offshore vendor partnership, to ensure our utilization management processes deliver timely and accurate decisions.</p><p><b><i>Your Responsibilities and Impact will include:</i></b></p><ul><li><p>Mission-Driven Clinical Leadership: Provide leadership and professional development to clinical and non-clinical teams. You will foster a culture of integrity and clinical excellence, ensuring all UM activities align with Devoted’s goal of treating members like family.</p></li><li><p>People &amp; Vendor Management: 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.</p></li><li><p>Technology &amp; AI Stewardship: We utilize a single internal technology platform across our business. You will play a key role in evaluating and prioritizing improvement opportunities to ensure our technology supports accurate and efficient workflows. You will be engaged with our AI tools for process and platform improvement while ensuring strict compliance with our AI Governance and Oversight policies.</p></li><li><p>Data-Driven Operations: Partner closely with Data Science and Engineering teams to identify key measurement points. You will be responsible for developing, implementing, and systematically monitoring comprehensive KPIs to ensure operational health and decision accuracy.</p></li><li><p>Regulatory &amp; Compliance Excellence: Partner with Compliance and Legal teams to ensure the operation is consistently audit-ready. You will digest complex regulatory guidance (e.g., NCDs, LCDs, Medicare Managed Care Manual) and translate it into compliant, high-quality operational workflows.</p></li><li><p>Strategic Stakeholder Collaboration: 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 also partner with Pharmacy UM