Provider Engagement Associate

Summary

Join Clover Health as a Provider Engagement Associate and contribute to our mission of reinventing health insurance by focusing on keeping people healthier. You will facilitate smooth interactions between providers and Clover, ensuring prompt issue resolution and supporting initiatives to improve provider satisfaction and patient outcomes. This role blends technical skills, operational knowledge, and strong interpersonal abilities to optimize provider relationships and efficiently resolve complex issues. The position requires in-depth knowledge of Clover Health's operational processes and strong data analysis skills. Success involves managing provider escalations, collaborating with internal and external teams, and implementing solutions to reduce provider abrasion. We are seeking candidates located in the Central and Eastern time zones of the United States.

Requirements

• You're based in the Central or Eastern time zone of the United States
• You're passionate about healthcare, with 3+ years of experience in health insurance or medical offices
• You have a Masters Degree or equivalent in healthcare, healthcare policy, or clinical credentials

Responsibilities

• Gain in-depth knowledge of Clover Health's operational processes, including Contracts, Claims Processing, Payments, Payment Integrity Audits, Configuration, and Grievances
• Serve as the main contact for high-priority providers and maintain positive on-going relationships, leading external meetings regularly
• Manage internal projects to enhance the provider experience, such as provider education on best practices and new policies
• Ensure timely investigation and resolution of escalated provider issues or inquiries, both internally and externally
• Work with internal and external teams to research and resolve provider escalations
• Identify and implement opportunities to reduce provider abrasion through root cause analysis and collaboration with management
• Utilize Excel; Pivot Tables, Formatting, Formulas, and Vlookups

Preferred Qualifications

• You have a knack for coding – maybe you're even a Certified Professional Coder (great if you are, but not a deal-breaker if you're not)
• You're a data wizard, comfortable with a variety of tools. Think Excel, Salesforce, JIRA, Mode, Google Suite, and industry-specific platforms like Engagement Plus, SDS, iNetwork, Optum Pay Financial, and Health Rules Payor
• Details are your thing, and you thrive on meeting deadlines
• You're a natural collaborator, excited to work with teams across our organization and beyond, helping us grow and innovate
• You're ready to bring your skills and experience to a dynamic, evolving industry

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