Director, Clinical Business Operations

November 22

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Clover Health

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Clover Health (Nasdaq: CLOV) is a physician enablement company focused on seniors who have historically lacked access to affordable, high-quality healthcareWe aim to provide great care, in a sustainable way, by having a business model built around improving medical outcomes while lowering avoidable costs. We do this while taking a holistic approach to understanding the health needs and social risk factors of those under our care. This strategy is underpinned by our proprietary software platform, the Clover Assistant, which is designed to aggregate patient data from across the health ecosystem to support clinical decision-making by presenting physicians and other providers with real-time, personalized recommendations at the point of care.Making care more accessible is at the heart of our business, and we believe patients should have the freedom to choose their doctors. We offer affordable Medicare Advantage plans with extensive benefits, provide primary care physicians with the Clover Assistant, and also make comprehensive home-based care available via the Clover Home Care program.With our corporate headquarters in Nashville, Clover’s workforce is distributed around the U.S. and also includes a team of world-class technologists based in Hong Kong. We manage care for Medicare Advantage members in Alabama, Arizona, Georgia, Mississippi, New Jersey, Pennsylvania, South Carolina, Tennessee, and Texas.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.If you’re a passionate person and interested in changing healthcare for the better, then Clover Health may just be the place for you.

501 - 1000 employees

📋 Description

• Lead financial and operational planning for Clover Care Services, including cost center oversight, budgeting, forecasting, and alignment of spend with visit volumes and growth goals. • In partnership with the Chief Operating Officer, manage vendor relationships and contracting, ensuring efficiency, compliance, and alignment with operational and financial objectives. • Oversee call center and scheduling operations performance for CCV operations (staffing levels, capacity, reach rates, scheduling utilization, productivity metrics) to optimize patient access and team efficiency. • Drive productivity and logistics management for clinical and administrative support functions, including visit volume tracking, staffing models, and capacity planning. • Support revenue cycle management by ensuring accurate and timely billing, claims processing, denial management, and issue resolution in partnership with Finance and Compliance. • Lead EHR systems oversight, including provider education, configuration management, and issue escalation to ensure seamless operational workflows. • Develop and implement standardized workflows and procedures that promote consistency, scalability, and operational excellence across care delivery support teams. • Partner in modeling and forecasting, developing data-driven projections for visits, enrollment, and staffing to guide strategic decision-making. • Collaborate cross-functionally with clinical and business leaders to align operational performance with quality, cost, and patient/member experience goals. • Monitor operational performance metrics and lead continuous improvement initiatives to increase efficiency and reduce cost per visit. • Ensure financial stewardship, including invoice review, spend tracking, and cost management for all CCS vendors and contractors. • Support OKR development and management, ensuring key performance indicators are aligned with organizational strategy and regularly reported.

🎯 Requirements

• You have 7+ years of experience in healthcare operations, finance, or business management, with at least 3+ years in a leadership role. • You have demonstrated success managing budgets, forecasting, and P&L elements in a healthcare or value-based care environment. • You bring deep operational experience in scheduling, logistics, revenue cycle, or care delivery support services. • You excel in data-driven decision-making and have advanced analytical and problem-solving skills. • You thrive in a matrixed, collaborative environment and can build relationships across clinical, financial, and technical teams. • You are passionate about creating systems and processes that make care delivery more efficient, accessible, and patient-centered.

🏖️ Benefits

• 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!