Director, Utilization Management Operations

Job Description

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.

A bit about this role:

At Devoted, our mission is to dramatically improve the health and well-being of our members by treating each of them like family. Devoted is growing at an incredible pace, and we are thrilled to welcome and serve every new member who joins us. This growth demands that our Utilization Management (UM) operation must scale and evolve without ever losing sight of the people at the center of every authorization.

We believe UM done right means decisions that are correct, fair, and fast, delivered through a frictionless process and with heart. Behind every request is a member waiting on care and a provider working to deliver it. UM is hard, but the challenge doesn’t exempt us from our mission.

We are seeking a curious, operationally minded leader to serve as Director, Utilization Management Operations. Reporting to the Vice President of Health Services, you will lead the teams behind our administrative work: a large onshore and offshore team of UM Administrative Coordinators who manage intake, outreach, notifications, and follow-up. You will also hold dotted-line accountability for monitoring and ensuring the success of our Part B medical authorization turnaround times (TAT).

This role is for someone who is energized by a complex process: someone who wants to unravel it, reimagine it, and lead the build of something simpler, faster, and more consistent. You will have significant influence over the roadmap for Orinoco, our internal technology platform, and an integrated AI engine to put to work. This role will help pave the way towards realizing the next generation of our UM program, driving improvements in effectiveness, efficiency, and experience for our members and provider partners.

Your Responsibilities and Impact will include:

• SLA & Timeliness Ownership: Own SLA performance for the administrative steps that support authorization review across UM, delivering consistent, predictable performance at a meaningfully lower cost. Hold dotted-line accountability for Part B medical authorization turnaround times (TAT), partnering with the clinical leaders of that team to monitor performance, surface risks early, and remove administrative barriers to on-time decisions.

• Process Reimagination: Map our administrative processes end to end, including auth intake, requests for additional clinical information, facility census checks, member and provider notifications, and member follow-up, and lead their redesign for speed, consistency, and simplicity.

• Technology & AI Leadership: Partner with Product and Engineering to shape the Orinoco roadmap so that process and technology evolve together. Put our integrated AI tools to work to remove manual effort, so our administrative capacity no longer has to grow at the same rate as our membership.

• Build for Measurement: Design processes that are highly measurable and transparent by default. Partner with Data Science to define and monitor the KPIs that matter, including timeliness, cost per authorization, quality, and provider experience, and use them to drive decisions and continuous improvement.

• People & Vendor Leadership: Lead and develop a team that includes approximately 50 onshore UM Administrative Coordinators and their leaders. Manage our offshore vendor partnership, which supports more than 250 administrative team members, holding it to clear performance standards while building a shared culture of ownership and care.

• Provider & Member Experience: Partner with the Provider Network team to understand what providers and facilities need from this process, and build it in. Design every touchpoint, from outreach to notifications to follow-up, with the humans on the other end in mind.

• Cross-Functional Partnership: Work closely with the Senior Director of UM, who owns end-to-end authorization performance, along with the UM Medical Directors, Compliance, Provider Network, Data Science, and Engineering teams to keep the operation aligned and consistently audit-ready.

Required skills and experience:

• Mission & Heart: A genuine commitment to treating members like family, and a belief that operational excellence and empathy belong together.

• Proven Operator at Scale: A track record of leading high-volume operations that deliver consistent SLA performance.

• Builder Mindset: Experience taking a complex, multi-step process apart and leading the build of a simpler, more scalable one, rather than only maintaining what exists. You are naturally curious and ask why a step exists before deciding how to improve it.

• Metrics-Oriented: You build for measurement, are comfortable working deep in the workflows and the data, and use both to drive decisions and hold teams and partners accountable.

• Technology & AI Curiosity: Experience…