Senior Data Submissions Operations Associate

Job Description

A bit about this role: 

We are seeking a meticulous and technically skilled Operations Senior Associate to lead the preparation, submission, and quality control of healthcare data and medical records to support normal operations and special projects. Special projects include CMS Risk Adjustment Data Validation (RADV) audits and Part C Improper Payment Measurement audits. This role is responsible for ensuring that all submissions to CMS are timely, accurate, compliant, and fully documented. You will act as one of a limited number of users of CMS data abstraction and data processing systems and serve as the primary liaison between Devoted Health, CMS, and internal technical teams. The ideal candidate combines operational precision and technical troubleshooting ability with strong awareness, compliance, and discipline handling sensitive healthcare data to ensure our submissions meet the highest quality standards—especially during high volume periods.

Your Responsibilities and Impact will include: 

• Own the end‑to‑end audit file submission process, including file validation, coversheet completion, and final upload via CMS portal.

• Coordinate and direct day‑to‑day work activities of assigned team members for submission‑related tasks, ensuring priorities, timelines, and quality standards are met; partner with Devoted’s internal management team to align assignments and resolve resource issues.

• Conduct detailed quality assurance checks on all files, ensuring alignment with CMS specifications (naming conventions, file size limits, date visibility, provider credentials, and document legibility).

• Monitor and triage submission feedback, routing issues to coding, file prep, compliance, or audit teams as appropriate.

• Maintain meticulous tracking of submission status, metadata, and resolution notes in internal audit logs.

• Partner closely with internal Tech and IT Submission teams to resolve system issues, optimize processes, and manage secure file transfers.

• Prepare and deliver submission metrics, error trends, and resolution summaries for RADV operations reporting; leverage SQL, Looker, or other BI tools to extract and analyze submission data where appropriate.

• Document and update standard operating procedures (SOPs) for submission, QA, and feedback resolution to ensure operational consistency.

Required skills and experience: 

• Proven experience in healthcare data submissions, medical record management, or health information operations, ideally in a Medicare Advantage or risk adjustment audit environment.

• Strong attention to detail with the ability to perform meticulous QA under time‑sensitive conditions.

• Ability to troubleshoot technical submission errors and partner effectively with IT and technical teams.

• Strong organizational skills and experience managing high‑volume workflows with compressed timelines.

• Experience collaborating with offshore resources or distributed teams, with the ability to clearly communicate priorities and task requirements without direct managerial authority

• Excellent communication and collaboration skills for working with cross-functional teams. 

Desired skills and experience: 

• Bachelor’s degree in Healthcare Administration, Health Information Management (HIM), Business, or related field. Relevant professional experience will be considered in lieu of a bachelor's degree.

• Proficiency with SQL, Looker, or other BI/database query tools for analyzing and validating submission data huge plus

• Experience working with CMS systems such as the Central Data Abstraction Tool (CDAT), Encounter Data Processing System (EDPS), or similar healthcare submission portals including familiarity with ICD‑10 coding or risk adjustment data.

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Salary range: ​$55,000 - $90,000 / year

The pay range listed for this position is the range the organization reasonably and in good faith expects to pay for this position at the time of the posting. 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 will 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:

• Employer sponsored health, dental and vision plan with low or no premium

• Generous paid time off

• $100 monthly mobile or internet stipend

• Stock options for all employees

• Bonus eligibility for all roles excluding Director and above; Commission eligibility for Sales roles

• Parental leave program

• 401K program

• And more....

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

Founded in 2017, Devoted Health is on a mission to dramatically improve the health and well-being of older Americans by caring for everyone like they are family, and that includes our employees. Our robust and seamlessly integrated care platform merges advanced data and AI access with world-class clinical and service experiences to create a member experience that is unlike the industry norm. To continue building upon our mission, we want to bring together those who share our values, embrace change and advancement, and are enthusiastic about where we're going — all the while bringing their own unique qualities, experiences, and expertise, in hopes of further changing the healthcare experience.

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.