- Job Type: Full-Time
- Function: IT
- Industry: Digital Health
- Post Date: 11/22/2022
- Website: cloverhealth.com
- Company Address: P.O. Box 471, Jersey City, NJ 07303
About Clover HealthClover Health is a data driven health insurance startup driving to improve the overall state of healthcare in America. We are hiring software engineers, data scientists, designers and product folks who can help us understand our members’ wellness and steer them clear of any health risks down the road.
Clover is reinventing health insurance by working to keep people healthier.
Clover Health is a Medicare Advantage and Prescription Drug plan that is changing how healthcare is delivered. The health care delivery system is undergoing many changes; however most health insurance payers are trying to execute this change with decades old processes and technologies in a top-down framework. In this role, you will have the opportunity to engage with forward thinking health systems with the goal of implementing programs in a data driven manner to improve the lives of our members.
You will be accountable for developing and executing the provider contracting and implementation strategy for a defined market. You will also be responsible for participating in the development of the network management strategy which includes aspects of technology product, utilization management, value-based care, membership growth, marketing, compliance, and member and provider experience.
As a Network Engagement Ancillary Associate , you will:
- Be the face of Clover to market's ancillary healthcare providers and serve as the primary point of contact for any/all assigned ancillary providers/practices.
- Support the formulation of various ancillary provider engagement strategies as part of building mutually beneficial partnerships in the provider network.
- Execute on ancillary provider contracting initiatives by engaging key providers throughout key markets.
- Manage ancillary provider contracting negotiations; engage contracted ancillary providers on a weekly basis.
- Engage all assigned accounts on a regular basis with the ultimate goal of enabling successful relationships, utilize key performance indicators in developing appropriate intervention strategies.
- Address and resolve operational challenges raised by network providers and effectively communicate those needs to internal stakeholders.
- Coordinate regular data transfer and feedback loops between ancillary providers and Clover to ensure internal & external administrative cohesion.
You will love this job if:
- You are an experienced negotiator and able to create win-win scenarios.
- You are passionate about transforming health delivery through data driven analysis and development of new technologies.
- You have an insatiable curiosity which feeds an appetite to learn and teach.
- 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 people person - you know how to communicate effectively to build trust and positive relationships with many different types of people, teams, and partners.
- 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 2+ years of experience in network management and ancillary provider contracting (such as Laboratory, SNF, Home Health, Dialysis, DME, etc.)
- You have a strong analytical and quantitative background.
- You have positive leadership skills and the ability to influence, collaborate and motivate others.
- You have a basic understanding of ancillary provider contract options, healthcare economics and competitor’s practices with the ability to grasp both clinical and business concepts.
- You have 2+ years of proven experience negotiating provider contracts to improve overall performance.
- You are able to create buy-in and drive action across a wide set of collaborative team members.
- You have a proven ability in using data to inform decision-making as part of a broader, strategic set of goals.
- You have a great understanding of healthcare topics, such as claims processing, EHRs, medical billing and coding and ancillary provider reimbursement models.
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.
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.