Job DescriptionA bit about this role:As the Appeals Program Manager at Devoted Health, you’ll be a key leader ensuring the accuracy, compliance, and effectiveness of our Appeals processes. Youll develop and oversee quality assurance (QA) tools, lead audit readiness efforts, and support operational teams and new hires with training and coaching.This is a hands-on, detail-oriented role that requires deep knowledge of CMS regulations and strong audit preparedness. You will collaborate with operations, compliance, and other stakeholders to ensure our processes meet internal and external standards.Your Responsibilities and Impact will Include:<ul><li>Develop and maintain quality assurance tools and audit mechanisms. This includes uploading monthly CPE audits, identifying deficiencies, and ensuring action plans are in place. You will also maintain and update standard operating procedures (SOPs) to reflect the latest regulatory and internal guidance.</li><li>Lead and support internal and external audits, including Program Audits, with the goal of achieving zero CARs (Corrective Action Requests) or ICARs (Immediate Corrective Action Requests). Youll also partner with the Compliance team on monthly check-ins, lead Part C reporting and timeliness metrics, and prepare all necessary documentation.</li><li>Represent the Appeals department in cross-functional efforts that impact reporting and operational processes. Youll monitor monthly trends from end-to-end audits and maintain accurate data for reporting.</li><li>Provide quality refreshers to existing team members and support new hire onboarding with structured quality training. Youll also coach and mentor staff on quality expectations and audit protocols.</li></ul>Required Skills and Experience:<ul><li>5+ years of experience in Medicare Advantage Appeals, Grievances, or healthcare quality assurance.</li><li>Deep understanding of CMS audit protocols and reporting requirements (e.g., CPE, Part C, Stars).</li><li>Strong organizational, project management, and attention to detail skills.</li><li>Excellent written and verbal communication skills.</li><li>Proven ability to lead cross-functional projects and drive accountability.</li></ul>Desired skills and experience:<ul><li>A proactive, hands-on leader who thrives on structure and process improvement.</li><li>Someone who enjoys building repeatable systems and documenting standard operating procedures.</li><li>A creative thinker who can find opportunities for improvement in the details.</li><li>Experience with quality tools and platforms like Looker, Monday.com, and Google Suite.</li></ul> #L1-DS1 #LI-Remote Salary range: $76,000-$110,000Our ranges are purposefully broad to allow for growth within the role over time. Once the interview process begins, your talent partner will provide additional information on the compensation for the role, along with additional information on our total rewards package. The actual base salary offered may depend on a variety of factors, including the qualifications of the individual applicant for the position, years of relevant experience, specific and unique skills, level of education attained, certifications or other professional licenses held, and the location in which the applicant lives and/or from which they will be performing the job.Our Total Rewards package includes:<ul><li>Employer sponsored health, dental and vision plan with low or no premium</li><li>Generous paid time off</li><li>$100 monthly mobile or internet stipend</li><li>Stock options for all employees</li><li>Bonus eligibility for all roles excluding Director and above; Commission eligibility for Sales roles</li><li>Parental leave program</li><li>401K program</li><li>And more....</li></ul>*Our total rewards package is for full time employees only. Intern and Contract positions are not eligible.Healthcare equality is at the center of Devoted’s mission to treat our members like family.  We are committed to a diverse and vibrant workforce. At Devoted Health, we’re on a mission to dramatically improve the health and well-being of older Americans by caring for every person like family. That’s why we’re gathering smart, diverse, and big-hearted people to create a new kind of all-in-one healthcare company — one that combines compassion, health insurance, clinical care, service, and technology - to deliver a complete and integrated healthcare solution that delivers high quality care that everyone would want for someone they love. Founded in 2017, weve grown fast and now serve members across the United States.  And weve just started. So join us on this mission!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.As an Equal Opportunity Employer, the Company does not discriminate on the basis of race, color, religion, sex, pregnancy status, marital status, national origin, disability, age, sexual orientation, veteran status, genetic information, gender identity, gender expression, or any other factor prohibited by law. Our management team is dedicated to this policy with respect to recruitment, hiring, placement, promotion, transfer, training, compensation, benefits, employee activities and general treatment during employment.