Senior Manager, Provider Escalation and Education

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Job Description A bit about this role: The Provider Escalation & Education (Prov Esc/Edu) team is dedicated to maintaining strong operational relationships with our Critical Provider Organizations (CPOs) while focused on building partnerships that reduce frustration through efficient issue management and proactive solutions. Our mission is to minimize unnecessary friction and demonstrate true partnership with our provider partners, solidifying Devoted as the health plan of choice and the preferred partner for provider organizations. We're looking for an exceptional leader to own and evolve the operational transformation of our Network Escalations (provider escalations via their network team contact) function. AI automation, digital workflows, and self-service are changing the cost and quality curve of operational work, creating a unique opportunity to reimagine Network Escalations as a modern, technology-enabled engine that delivers better provider experience, faster responses to complex problems, upstream issue detection, and stronger quality. In this role, you'll lead both the team and the day-to-day operational excellence of our Provider Complex Case Team that handles Network Escalations and the design, implementation, and ownership of its next-generation operating model. We're looking for a systems-minded operator who can own outcomes end to end - a true builder-operator who can lead a service organization today while designing, implementing, and owning the workflows, systems, and tooling that will define how the function operates in the future. A key responsibility will be direct engagement with critical provider groups during escalations, including face-to-face meetings to build trust, resolve issues, and reinforce long-term relationships. Additionally, by driving upstream operational initiatives, the Sr. Manager will identify key pain points and collaborate with cross-functional teams to charter and implement innovative program solutions that mitigate future escalations and improve overall operational performance. This role is pivotal in fostering a culture of proactive problem-solving and continuous improvement within the team. The best candidate will combine operational excellence, systems thinking, obsession with detail, pace- setting execution, and the ability to create confidence through change. This role is ideal for someone who organizes around metrics and outcomes, runs to hard problems, has a strong track record of achieving results, and thrives in ambiguity while building durable systems that outlast any one leader. Your Responsibilities and Impact will include: Ownership of Devoted's Network Escalations function, including service levels, quality, provider experience, operational performance, compliance, and cost Leading a team of subject matter experts that resolve network escalations Running the current machine while designing, implementing, and owning the future-state machine Defining and executing the roadmap for modernizing through AI, workflow automation, and self-service Establishing clear visibility into units of work, productivity, quality, cost, and performance metrics Be a Change Maker: This is an opportunity to make a real impact, ensuring our provider partners feel valued and respected while reinforcing our mission to minimize frustration and strengthen relationships. Foster Strong Provider Relationships: Meet with providers to resolve escalations and deliver proactive performance insights, actively engaging to understand their needs and challenges. Building and operationalizing AI-enabled and human-in-the-loop workflows that improve quality, consistency, speed, and provider satisfaction Managing the function through rigorous metrics, KPIs, scorecards, and performance dashboards, with clear accountability for outcomes Partnering cross-functionally with Network and other health plan operations teams to solve upstream drivers of provider issues and improve end-to-end provider experience Leading through significant evolution while creating confidence, momentum, stability, and strong culture through change Raising the talent bar across the organization by setting the pace and modeling high standards Required skills and experience: At least 5 years of leadership experience with a track record of delivering measurable outcomes in complex operational environments Outstanding operational rigor with the ability to deploy technology to solve complex business challenges Proven experience driving end-to-end initiatives from strategy through execution that materially improve quality, service levels, cost, compliance, or operational efficiency Demonstrated ability to manage through metrics, establish ambitious targets, and drive teams to results with clear accountability Exceptional attention to detail and precision, with a reputation for sweating the details and getting the hardest operational last mile right Clear evidence of urgency, resilience, and the ability to

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