Manager, Value-Based Care

Summary

Join Clover Health's Medicare Advantage Finance Operations team as a Manager of Value-Based Care, leading initiatives to design, implement, and optimize value-based payment models. You will drive provider performance through data-driven Joint Operating Committees and shape Clover’s value-based strategy. This critical role involves building scalable payment operations, leveraging automation and technology, and collaborating with cross-functional teams. You will facilitate Joint Operating Committee meetings, track performance, identify improvement opportunities, and build trusted relationships with partners. Success will be measured by the efficiency and effectiveness of value-based care initiatives, including optimized payment models and improved provider performance.

Requirements

• You have 5+ years of experience in healthcare operations, value-based care, provider strategy, finance, or a related field; experience in Medicare Advantage is strongly preferred
• You have a strong understanding of value-based care models (e.g., capitation, shared savings, risk adjustment) and the operational implications of provider contracting and reimbursement
• You have a Bachelor’s degree in business, health administration, finance, or related field required; advanced degree (MBA, MHA, MPH) a plus
• You have proven ability to lead cross-functional initiatives and manage complex stakeholder relationships
• You have experience working directly with provider organizations, MSOs, or payers in a collaborative capacity
• You have strong analytical skills with a data-driven mindset; proficiency in Excel required; SQL or similar data tools a plus
• You have excellent communication skills, with the ability to lead effective meetings and synthesize complex information clearly
• You are comfortable working in a fast-paced, ambiguous environment with a proactive and solutions-oriented approach

Responsibilities

• Build Scalable Payment Operations
• Design and implement scalable and repeatable processes to support timely, accurate payments to providers under existing and future value-based care models
• Leverage automation and technology to streamline operations and improve efficiency, accuracy, and transparency
• Partner with Clover’s Finance, Engineering, and Claims teams to build robust infrastructure and tooling for value-based care payments
• Provider Collaboration & Performance Management
• Facilitate and lead recurring Joint Operating Committee (JOC) meetings with Clover’s Management Services Organization (MSO), ensuring alignment on clinical and financial performance objectives
• Track performance against shared goals, identify improvement opportunities, and drive accountability through data-driven discussions
• Build trusted relationships with partners across lines of business, serving as a key operational liaison
• Strategic Model Development
• Serve as a strategic thought partner across Clover’s cross-functional teams to continuously evolve our approach to value-based care
• Support the design of innovative payment models that align incentives and improve patient outcomes
• Stay current on regulatory, industry, and market trends to inform Clover’s strategy

Benefits

• 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
• We prioritize the health and well-being of our employees and their families by providing comprehensive medical, dental, and vision coverage
• 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
• Developing internal talent is a priority for Clover
• We offer learning programs, mentorship, professional development funding, and 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