Clover is reinventing health insurance by working to keep people healthier.
We are looking for a Senior Associate to join our Provider Data Management team. You will make sure that our programs run efficiently and effectively. You will prioritize and manage your time among many projects and be proactive in asking questions, raising concerns, and making suggestions for improvement. In this role, you will work on existing and yet-to-be developed processes, keeping everything running smoothly.
As a Provider Data Management Senior Associate, you will:
- Develop systems and workflows to support the Provider Data Operations team at Clover
- Work cross-functionally with stakeholders across Clover to improve how data is collected, validated and maintained
- Develop service level agreements to ensure clear communication and handoffs occur between upstream and downstream teams
- Build reporting tools to provide greater visibility into where data gaps exist, and develop action plans to improve data quality
- Partner with Product, Data Operations and Engineering to set business rules that govern how data is validated against third-party sources
- Coordinate data transfer and feedback protocols between the Provider Data Management team and internal operations teams to ensure core operations are smooth and prevent escalations
- Develop Policies and Procedures to document CMS regulatory requirements and how Clover can appropriately meet them
You will love this job if:
- You are passionate about transforming the health delivery through data driven analysis and development of new technologies.
- You enjoy building processes from scratch. You are always looking to improve experience and efficiency.
- You use analytical input to solve complex problems.
- You are keen on learning and sharing knowledge.
You should get in touch if:
- You are able to identify opportunities for improved efficiencies between internal operations team that collect and handle provider data.
- You're detail oriented and can develop processes and report to quickly identify outlier data elements.
- You enjoy analyzing and summarizing large sets of data to identify actionable insights.
- You have experience or a desire to learn SQL based reporting.
- You have an understanding of compliance and payer requirements including Medicare regulations (preferred).
- You have a thorough understanding of healthcare topics, such as claims processing, EHRs, medical billing and coding and physician reimbursement models (preferred).
- You have experience in operations and performance improvement.
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.