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🕒 July 31

🏖️ New Jersey, Pennsylvania, +1 more states – Remote

🏖️ New Jersey – Remote 🔔 Pennsylvania – Remote 🌴 South Carolina – Remote

💵 $115.4k - $150k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 23%

What it means: the chance that no one is really hiring for this job.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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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 the primary liaison between Network Performance and specialist providers • Drive the Specialist Optimization Initiative and translate analytics into provider action and measurable performance improvement • Develop and maintain relationships with specialist providers • Lead data-driven discussions about utilization trends, referral patterns, site-of-service opportunities, and practice variation • Identify barriers to outpatient utilization and implement clinically appropriate efficiency strategies • Educate and support providers on scheduling behaviors and network optimization goals • Monitor adoption of recommended practice changes and shifts in referral behavior • Use analytics reporting to identify utilization opportunities, prioritize outreach, and measure intervention effectiveness • Track, analyze, and report KPIs including ASC utilization, outpatient migration, provider engagement, conversion and adoption rates, network improvements, and cost savings • Provide leadership feedback on provider performance trends and intervention opportunities • Collaborate with Analytics, Clinical, and Network Performance teams • Support value-based arrangements, strategic rate negotiations, and specialist network enhancements • Develop and execute strategies improving network efficiency, affordability, and member outcomes • Travel up to 50%, primarily within New Jersey and Pennsylvania, with some travel to South Carolina and Georgia

🎯 Requirements

• Reside in New Jersey or within the tristate area with the ability to travel up to 50% • Experience working with providers, health plans, value-based care organizations, or healthcare consulting teams to improve performance outcomes • Prior experience with provider contracting, rate negotiation, or network development • Ability to use data to uncover opportunities and turn insights into measurable operational change • Confidence leading difficult conversations around utilization patterns, practice variation, and performance improvement opportunities • Track record of driving adoption, influencing behavior change, and achieving quantifiable results • Ability to thrive in fast-paced environments where strategy, analytics, relationship management, and execution intersect

🏖️ 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 supporting collaboration and flexibility • 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 • Remote-first culture, enabling collaboration with global teams • Paid parental leave for all new parents

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