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Director, Clinical Transformation

Clover Health

Remote / North America
  • Job Type: Full-Time
  • Function: Clinical Research
  • Industry: Digital Health
  • Post Date: 03/15/2023
  • Website:
  • Company Address: P.O. Box 471, Jersey City, NJ 07303
  • Salary Range: $50,000 - $150,000

About Clover Health

Clover 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.

Job Description

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


We value diversity — in backgrounds and in experiences. Healthcare is a universal concern, and we need people from all backgrounds and swaths of life to help build the future of healthcare. Clover's Value Based Care team is responsible for the development and implementation of programs to support the growth and long term success of our Direct Contracting / ACO REACH initiative, and other value based programs


We are hiring for a Director, Clinical Transformation who will report to the Chief Medical Officer of Value Based Care and oversee the implementation and success of clinical initiatives across Clover’s ACO network. 

As a Director, Clinical Transformation, you will:

  • Under the direction of the CMO, develop and maintain the provider maturity model that is used to identify a provider's current state and next steps on the journey to value based care risk models.
  • Grow with the organization in scope and scale of responsibility.
  • Lead a growing team of Clinical Transformation Specialists to improve performance in quality and cost across the ACO network(s).  These Specialists each:
    • Work directly with 1 or 2  large group practices/conveners to assess current state, share performance reporting, design work plans for initiatives to move up the maturity scale, guide process improvement implementations, and guide care management program implementation to impact total cost of care and quality outcomes. 
    • Serve as the key point of contact for 1 to 2 large group practices/conveners, taking in all issues and ensuring issue resolution by leveraging operations specialists, and other value based care team members.
  • Take responsibility for 1 to 2 large groups from time to time.
  • Organize and lead monthly collaboration and performance review meetings with each large group practice/convener arranging for support from analytics, medical directors, CMO, etc.
  • Be actively involved in care management strategy, design, planning, and innovation. 
  • Provide standardized update reporting to the CMO and Sr. Leadership team on large group practice/convener performance, return to green plans, initiatives progress/barriers, and projected time to complete the next step in the maturity model.
  • Be directly accountable for achieving MCR targets.
  • Be a relationship builder and actively solve problems and identify opportunities for improvement.


You will love this job if:

  • You are service oriented — you feel fulfilled in helping and supporting others to achieve common goals and resolve issues.
  • You are a team player. You enjoy partnering with others, and want to work collaboratively to find new solutions.
  • You are a strong communicator. You have strong verbal and written communication skills that foster trust, knowledge sharing, and progress.
  • You are detail-oriented. You pay attention to the small things, while understanding how they fit into the bigger picture.
  • You have a bias to action and love to move quickly from ideas to execution.
  • You use analytical input to solve complex problems.
  • You are curious. You like to do research when you don't know an answer. You ask the hard questions and you don't sweep problems under the rug.

You should get in touch if:

  • You have a 5+ years Medicare healthcare experience, ideally in value-based care.
  • You have 3+ years experience supporting provider engagement in an outpatient/clinic setting.
  • You have 2+ years experience leading a team to drive improvement in a healthcare setting.
  • You have a great understanding of healthcare topics, such as EHRs, clinic workflows, medical billing and coding and physician reimbursement models.
  • You have a working understanding of healthcare topics, pertaining to providers, such as, value based care, population health, physician reimbursement models, data sharing in provider partnerships, and PCP engagement.
  • You have a basic understanding of provider contract options, healthcare economics and competitors practices with the ability to grasp both clinical and business concepts.
  • You have strong project management or administrative skills and can multi-task while being highly organized and thorough. 
  • 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 are able to regularly identify opportunities to implement efficient process/operational improvements.
  • You have a working knowledge of Excel and are able to produce basic reports when requested.

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