Job Description

A bit about this role:

The Claims AI Operations Lead will lead the transformation of our Claims operational model into an AI-native ecosystem. Reporting to the VP of Claims, you will design, implement, and continuously optimize a hybrid operating model that blends AI agents and human operators to drive efficiency, quality, and innovation across day-to-day claims operations.

Embedded directly within the Claims organization, you will serve as the bridge between operational reality and technological capability. You will work in close partnership with Technology teams to extend the impact of existing tools and identify new opportunities that require technical development or integration. You will ensure that AI systems and our claims talent work seamlessly together—delivering measurable outcomes and building a more adaptive, data-driven operating model.

Your Responsibilities and Impact will include:

• Operational Transformation: Redefine claims workflows to leverage AI agents and automation, ensuring end-to-end processes are optimized for speed, accuracy, explainability, and scalability. You will partner with operational leaders to reimagine service delivery through AI-native design principles.

• AI Agent Orchestration: Design, build, and oversee AI agents (task-specific and multi-agent systems), integrating them seamlessly into existing claims workflows.

• Human–AI Collaboration: Define orchestration models and accountability frameworks for hybrid human–AI work. You will establish clear protocols for how AI systems and claims operators interact—including task assignment, escalation paths, and oversight protocols.

• Monitoring & Governance: Implement monitoring frameworks to track AI agent performance, data quality, cost, and drift. You will collaborate with compliance and risk partners to ensure safe and responsible AI use within the highly regulated insurance environment.

• Cross-Functional Collaboration: Partner closely with Product, Engineering, and Data teams to ensure operational needs inform technology priorities. You will translate operational insights into actionable feedback for technology teams to extend and refine existing tools.

• Training & Enablement: Build programs that elevate AI fluency across the Claims organization. You will equip frontline operators and managers with the skills and confidence to supervise and collaborate effectively with AI systems.

• Innovation & Experimentation: Lead pilots and structured experiments to test new agentic patterns, workflows, or orchestration strategies.

• Metrics & Outcomes: Define and track KPIs for human–AI collaboration, such as throughput, decision accuracy, automation coverage, and cost-to-serve.
  

Required skills and experience:

• AI & Technical Fluency: Deep understanding of AI systems, automation platforms, and LLM-based agent orchestration frameworks with 1+ years of hands-on experience applying generative AI in real-world workflows, products, or operational use cases.

• Data & Operational Insights: Proficiency with data, analytics, and business intelligence platforms (e.g.,Snowflake or Looker) to drive AI-driven decision-making and bridge the gap between business challenges and technical opportunities.

• Operational Excellence: Background in technology, operations, or process re-engineering, ideally within a scaled service or technical environment. You are a strong systems thinker who can visualize the end-to-end claims lifecycle.

• Change Management: Excellent communication skills with the ability to influence across disciplines. You can champion a culture of confident and ethical AI adoption, helping frontline teams pivot to new ways of working.

• Relationship Builder: Proven ability to build strong cross-functional relationships, prioritizing collaborative and empathetic communication with Product, Engineering, and Data teams.

• Strategic Analytical Horsepower: Proven ability to leverage complex data sets to inform strategic initiatives, while articulating compelling, data-driven narratives that drive organizational vision.

• Bachelor’s degree required, or equivalent work experience.

Desired skills and experience:

• Experience in healthcare technology, insurance claims, or tech operations is strongly preferred.

• Proven ability to thrive in a fast-paced startup environment.

• Passion for experimentation, continuous learning, and building the next generation of AI-augmented operations.

Salary range: $140,000 - $200,000 /year (also eligible for cash bonus and stock options)

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.

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, we've grown fast and now serve members across the United States. And we've 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.