MSO Operations Associate

Job not on LinkedIn

🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $63.8k - $83k / year

⏰ Full Time

🟢 Junior

🟡 Mid-level

⚙️ Operations

🚫👨‍🎓 No degree required

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 0%

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Clover Health

WebsiteLinkedInAll Job Openings

501 - 1000 employees

🏥 Healthcare

🛡️ Insurance

🤖 Artificial Intelligence

Healthcare • Insurance • Artificial Intelligence

Clover Health is a healthcare technology company helping members live their healthiest lives with our Medicare Advantage plans. Focused on seniors who have historically lacked access to affordable and high-quality healthcare, Clover aims to provide care sustainably by improving medical outcomes while simultaneously lowering avoidable costs. They leverage a proprietary software platform, the Clover Assistant, to aggregate patient data and offer real-time recommendations to healthcare providers. Their services include affordable Medicare Advantage plans, a home care program, and they manage care for Medicare Advantage members across several U. S. states.

📋 Description

• Serve as a resource and support for team members navigating operational workflows • Monitor and track Payment Exception status, including PE, UST/config, and Tier 3 matters • Attend recurring claims status meetings and ensure timely follow-up on action items • Execute Contract Signature Workflow, including Medication Adherence, Docusign/bilateral, CAQH checks, and preparation for Network Operations handoff • Qualify Growth Leads received through website, direct, Salesforce, and other channels • Monitor and track Contract Signature-to-Activation workflows • Route and triage escalations from field teams to appropriate internal stakeholders • Support provider activation workflows, including intake tracking, documentation readiness, and go-live coordination • Monitor Clover Home Care referrals and other onboarding milestones, proactively flagging delays • Update MSO reporting sources regularly and ensure accuracy and timely completion by deadlines • Maintain dashboards and tracking tools for team performance visibility • Attend routine and ad-hoc operational meetings and perform other assigned duties • Facilitate document management, storage, and maintenance

🎯 Requirements

• Experience in an administrative or operational support role, preferably within a healthcare or managed care setting • Highly organized with strong time-management skills and ability to manage multiple active workflows simultaneously • Excellent attention to detail, particularly for claims tracking, reporting accuracy, and documentation completeness • Proficiency with Google Sheets, SharePoint, CRM systems, and tools for updating metrics and generating reports • General understanding of healthcare concepts, including HEDIS, claims processing, EHRs, medical billing and coding, reimbursement models, and Medicare/Medicare Advantage (preferred) • Proactive, self-motivated team player able to follow through with minimal supervision • Clear communication and effective cross-team collaboration

🏖️ Benefits

• Competitive base salary • Equity opportunities • Performance-based bonus program • 401k matching • Regular compensation reviews • Comprehensive medical, dental, and vision coverage • No-Meeting Fridays • Monthly company holidays • Mental health resources • Generous flexible time-off policy • Remote-first culture • Learning programs • Mentorship • Professional development funding • Regular performance feedback and reviews • Employee Stock Purchase Plan (ESPP) offering discounted equity opportunities • Reimbursement for office setup expenses • Monthly cell phone & internet stipend • Paid parental leave for all new parents