Provider Solutions Associate

Clover is reinventing health insurance by working to keep people healthier.

Clover Health is dedicated to reinventing health insurance by focusing on keeping people healthier. This mission is reflected in our approach to managing provider relationships and ensuring that operational needs are met efficiently. 

As a Provider Solutions Associate, you would contribute to this mission by facilitating smooth interactions between providers and Clover, ensuring that any issues are promptly resolved, and supporting initiatives aimed at improving overall provider satisfaction and patient outcomes. This role requires a blend of technical skills, operational knowledge, and strong interpersonal abilities to ensure that Clover Health's provider relationships are optimized and that complex issues are resolved efficiently.

We are currently considering candidates located in the Central and Eastern time zones of the United States for this position.

As a Provider Solutions Associate, you will:

• 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.

Success in this role looks like:

Success in this role is measured by your ability to complete key tasks like data entry, report generation, and provider claims analysis accurately within the first 90 days. You'll also research and resolve escalations, gain a strong understanding of Clover's policies, and collaborate effectively with internal teams. By the first 6 months, you'll be expected to manage higher-level escalations, independently handle hospital systems, maintain the Provider Claims Escalation spreadsheet with precision, and contribute to internal projects. Long-term success involves building strong relationships with providers, efficiently managing projects, resolving escalations, and applying problem-solving skills while multitasking with minimal oversight.

You should get in touch if:

• 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 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 Overview:

• Financial Well-Being: 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.
• Physical Well-Being: We prioritize the health and well-being of our employees and their families by providing comprehensive medical, dental, and vision coverage. Your health matters to us, and we invest in ensuring you have access to quality healthcare.
• Mental Well-Being: 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. 
• Professional Development: Developing internal talent is a priority for Clover. We offer learning programs, mentorship, professional development funding, and regular performance feedback and reviews.

Additional Perks:

• 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
• And much more!

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 and analytics to empower our clinical staff to intervene and provide personalized care to the people who need it most.

We always put our members first, and our success as a team is measured by the quality of life of the people we serve. Those who work at Clover are passionate and mission-driven individuals with diverse areas of expertise, working together to solve the most complicated problem in the world: healthcare.

From Clover’s inception, Diversity & Inclusion have always been key to our success. We are an Equal Opportunity Employer and our employees are people with different strengths, experiences and backgrounds, who share a passion for improving people's lives. Diversity not only includes race and gender identity, but also age, disability status, veteran status, sexual orientation, religion and many other parts of one’s identity. All of our employee’s points of view are key to our success, and inclusion is everyone's responsibility.

#LI-REMOTE

Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records. We are an E-Verify company.

For California, Colorado, New Jersey, New York, or Washington residents, a reasonable estimate of the base salary range for this role can be found below. For candidates residing in other geographic areas, the range will be adjusted based on location. Final pay is based on several factors including but not limited to internal equity, market data, and the applicant’s education, work experience, certifications, etc.

Colorado/Washington Pay Range

$67,200 - $91,800 USD

California/New Jersey/New York Pay Range

$67,200 - $102,000 USD