Membership Operations Associate at Clover Health
San Francisco, CA, US

Clover is reinventing health insurance by working to keep people healthier.

The Membership team is a group of dedicated, hard-working, enthusiastic individuals working at the heart of insurance operations. This team maintains the business function of our enrollment and premium billing activities, including ensuring accuracy and timeliness of enrollment applications, maintaining CMS compliance, resolving escalated issues, and ensuring accurate member data throughout the member's journey with Clover. The team also works on projects to improve the efficiency and accuracy of cross-functional activities of Insurance Operations. The success of insurance operations relies on collaboration with our internal counterparts: Claims, Utilization Management, Appeals, Grievances, and Customer Experience.

As an Operations Associate at Clover, you will lead a team to high-quality outcomes and have a strong conviction that health insurance can and should be better. We are looking for someone who is relentless in his or her quest to elevate the performance and Membership team members and the Insurance Operations as a whole. This person will actively identify gaps and opportunities for improvement with an eye for scalability. The Operations Associate will need to learn, adapt, and roll with the company's mission to change the payer landscape for the better, and bring a team alongside in that journey.

As an Operations Associate, you will:

  • Manage the day-to-day tasks and output of the Membership Coordinators and Specialists. Provide ongoing support, training, and coaching to grow the Coordinators and Specialists in their current roles and in preparation for their future roles.

  • Manage the output of the Membership Coordinators and Specialists to steadily improve the Membership function in a reactive, proactive, and measurable manner. This includes overseeing daily activities of Coordinators and Specialists on the Membership team, managing work queue assignments, maintaining service level agreements, and ensuring quality and compliance.

  • Work autonomously on day-to-day tasks with minimal guidance on projects or other assigned work.

  • Work on quantitative metrics which will include but are not limited to a number of queue item worked, queue item SLA's, and quality assurance scores.

  • Work with the Operations Manager to help develop, implement and facilitate processes that focus on achieving measurable improvements that are efficient, scalable, and result in improved member experience.

  • Be an advocate for our members in all Clover systems and processes.

You will love this job if:

  • You have strong leadership skills. You know how to maximize the productivity of a team and drive results.

  • You want to make an impact. You thrive off of helping others and want your work to make a difference in our members' lives, while also advocating for their needs.

  • You are a clear and concise communicator and know how to tailor your message to your audience.

  • You are a people person - you know how to communicate effectively to build trust and lasting partnerships with many different types of people, teams, and stakeholders.

  • You have a critical and analytical mindset. You understand how all the components of a process fit together and believe in the value of making data-driven decisions; you continuously monitor the efficacy of your programs through metrics tracking.

  • You are nimble, and comfortable working in a constantly evolving environment. You embrace ambiguity and speed while maintaining a bias towards action.

You should get in touch if:

  • You have 3+ years of supervisory experience in a highly regulated environment.

  • You can dig into the weeds but also think big picture - you are able to relate the inputs and outputs of systems or processes to their overall business value and impact.

  • You have some healthcare or start-up (or healthcare start-up) experience, although not required.

  • You have (or are excited to develop) strong SQL skills.

  • You are excited by the prospect of building a better healthcare system from the ground up.

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.

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.

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