Clover is reinventing health insurance by working to keep people healthier.
Clover Health is a Medicare Advantage & 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 & 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.
In this role, you will be accountable for developing & executing the network development & provider contracting strategies for the various markets. You will also be responsible for participating in the development of the network management strategy which includes aspects of technology & product development, utilization management, value-based care, membership growth, marketing, compliance, & member & provider experience.
As a (Senior) Associate of Network Development & Contracting, you will:
- Support network development & contracting goals within designated geographies.
- Develop & refine local contracting strategies to drive provider participation in Medicare Advantage, Direct Contracting & other value-based initiatives.
- Support development & contracting strategies to drive engagement of Clover's flagship technology platform, the Clover Assistant.
- Track, document & manage all provider contracting activities.
- Address & resolve any concerns or challenges raised by providers & effectively communicate those solutions to internal stakeholders.
- Engage & partner cross-functionally with marketing, legal, finance, customer success & other internal teams to support contracting & development opportunities.
You will love this job if:
- You are an experienced negotiator & able to create win-win scenarios.
- You are passionate about transforming the health delivery system through data driven analysis & development of new technologies.
- You have an insatiable curiosity which feeds an appetite to learn & teach.
- You want to make an impact. You thrive off of helping others & 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 & positive relationships with many different types of people, teams, & partners.
- You are nimble, & comfortable working in a constantly evolving environment. You embrace ambiguity & speed while maintaining a bias towards action.
You should get in touch if:
- You have experience in network development, recruitment, contracting, business development, network management, and/or managed care.
- You have a strong analytical & quantitative background.
- You have positive leadership skills & the ability to influence, collaborate & motivate others.
- You have a basic understanding of provider contract options, healthcare economics & competitors practices with the ability to grasp both clinical & business concepts.
- You have proven experience negotiating provider contracts to improve overall performance.
- You are able to create buy-in & 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 & coding & physician reimbursement models.
Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest & 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 & analytics to empower our clinical staff to intervene & provide personalized care to the people who need it most.
We always put our members first, & our success as a team is measured by the quality of life of the people we serve. Those who work at Clover are passionate & mission-driven individuals with diverse areas of expertise, working together to solve the most complicated problem in the world: healthcare.
From Clovers inception, Diversity & Inclusion have always been key to our success. We are an Equal Opportunity Employer & our employees are people with different strengths, experiences & backgrounds, who share a passion for improving people's lives. Diversity not only includes race & gender identity, but also age, disability status, veteran status, sexual orientation, religion & many other parts of ones identity. All of our employees points of view are key to our success, & inclusion is everyone's responsibility.