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Clover is reinventing health insurance by working to keep people healthier.
Clover Health is a Medicare Advantage plan transforming healthcare delivery. While many payers rely on outdated methods, we take a data-driven approach to improve our members' lives.
This role is the primary point of contact between Clover Health’s hospital and ancillary partners, including Fee-For-Service and Pay-for-Performance providers. It requires expertise in provider relations, claims, HEDIS, contract reimbursement, and partnership development to engage high-priority providers, such as managed care and revenue cycle departments, ensuring provider satisfaction and education on Clover's initiatives.
Under general supervision, you’ll work directly with external providers to educate, advocate, and foster compliance with Clover policies while delivering top-tier customer service. You’ll also drive timely issue resolution, support growth initiatives, manage HEDIS Gaps-in-Care, and resolve complex issues involving senior leadership. Additionally, you’ll serve as a subject matter expert for other departments.
We are currently considering candidates located in the Central and Eastern time zones of the United States for this position.
As a Hospital & Ancillary Relations Manager you will:
- Be the face of Clover to providers, driving engagement and fostering strong relationships that support our mission to improve healthcare.
- Shape provider partnerships, working closely with key players to implement innovative strategies that benefit both providers and our members.
- Lead process improvements, tackling challenges head-on to streamline operations and enhance collaboration with hospitals across various markets.
- Solve problems on the spot, offering guidance, resolving issues, and ensuring satisfaction for both providers and internal stakeholders.
- Deliver impactful training and education to healthcare teams, helping them understand and embrace Clover’s initiatives.
- Drive meaningful discussions with senior leadership, providers, and physicians to resolve complex healthcare issues, from utilization management to quality of care.
- Promote provider success, leveraging Clover’s advanced tools and programs to improve efficiency, patient satisfaction, and compliance with healthcare regulations.
Success in this role looks like:
In the first 30 days, you'll build relationships with key teams, establish regular check-ins with Network leads, and begin planning market priorities. By 60 days, you'll fully operationalize these priorities, lead contract review sessions, and provide performance updates to leadership. By 90 days, you'll have operationalized network management objectives, developed strong cross-functional relationships, and initiated improvements in network processes.
You should get in touch if:
- You're based in the Central or Eastern time zone of the United States.
- You have experience in network management, provider relations, or managed care, and are passionate about building strong partnerships with providers.
- You’re skilled in Medicare Inpatient and Outpatient claims with a knack for digging into data and solving problems.
- You’re a natural leader who loves inspiring and motivating others to work together and achieve great results.
- You understand provider contracts, healthcare economics, and the broader competitive landscape, and can easily connect clinical and business ideas.
- You’ve tackled complex claims and billing issues, improving performance and efficiency.
- You know how to bring people together, create buy-in, and get things done with a diverse group of team members.
- You’re comfortable using data to drive decisions and shape the big picture.
- You’re knowledgeable about healthcare topics like claims processing, EHRs, billing, coding, and reimbursement models.
Benefits Overview:
- Financial Well-Being: Our commitment to attracting and retaining top talent begins with a competitive base salary and equity opportunities. Additionally, we offer a performance-based bonus program, 401k matching, and regular compensation reviews to recognize and reward exceptional contributions.
- Physical Well-Being: We prioritize the health and well-being of our employees and their families by providing comprehensive medical, dental, and vision coverage. Your health matters to us, and we invest in ensuring you have access to quality healthcare.
- Mental Well-Being: We understand the importance of mental health in fostering productivity and maintaining work-life balance. To support this, we offer initiatives such as No-Meeting Fridays, monthly company holidays, access to mental health resources, and a generous flexible time-off policy. Additionally, we embrace a remote-first culture that supports collaboration and flexibility, allowing our team members to thrive from any location.
- Professional Development: Developing internal talent is a priority for Clover. We offer learning programs, mentorship, professional development funding, and regular performance feedback and reviews.
Additional Perks:
- Employee Stock Purchase Plan (ESPP) offering discounted equity opportunities
- Reimbursement for office setup expenses
- Monthly cell phone & internet stipend
- Remote-first culture, enabling collaboration with global teams
- Paid parental leave for all new parents
- And much more!
About Clover: We are reinventing health insurance by combining the power of data with human empathy to keep our members healthier. We believe the healthcare system is broken, so we've created custom software and analytics to empower our clinical staff to intervene and provide personalized care to the people who need it most.
We always put our members first, and our success as a team is measured by the quality of life of the people we serve. Those who work at Clover are passionate and mission-driven individuals with diverse areas of expertise, working together to solve the most complicated problem in the world: healthcare.
From Clover’s inception, Diversity & Inclusion have always been key to our success. We are an Equal Opportunity Employer and our employees are people with different strengths, experiences and backgrounds, who share a passion for improving people's lives. Diversity not only includes race and gender identity, but also age, disability status, veteran status, sexual orientation, religion and many other parts of one’s identity. All of our employee’s points of view are key to our success, and inclusion is everyone's responsibility.
#LI-REMOTE
Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records. We are an E-Verify company.
For California, Colorado, New Jersey, New York, or Washington residents, a reasonable estimate of the base salary range for this role can be found below. For candidates residing in other geographic areas, the range will be adjusted based on location. Final pay is based on several factors including but not limited to internal equity, market data, and the applicant’s education, work experience, certifications, etc.
Colorado/Washington Pay Range
$83,200 – $114,300 USD
California/New Jersey/New York Pay Range
$83,200 – $127,000 USD
