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Clover Health

Clover Health is a unique health insurance plan focused on driving down costs and producing improved health outcomes.

Senior Manager, Interoperability
United States of America
Job Description / Skills Required

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

Interoperability at Clover is essential to our Technology organization. We identify opportunities where data and technology can be most impactful and deliver a detailed execution to measurably improve the health of our population.

As a new role for Clover's tech organization, you'll help clinical leadership drive strategic alignment between Clover's technical and operational teams when supporting interoperability between health information technology systems across our network and Clover products (including our internal-facing data platform). You will be an integral member in embedding effective processes in support of execution and stakeholder management. Our ideal person will help increase the team's productivity and help shape the way we support all of our product and technology investments.

Clover integrates with multiple third parties, from vendors that support our clinical programs and applications to EMR systems. In this role, you'll own the end-to-end execution of such projects. From a technology standpoint, these projects typically involve working with complex clinical data sets in order to develop data migrations (ETL), web services, Electronic Data Interchanges (EDI) and the use of SMART on FHIR API standards. From a project management perspective, it requires bridging Technology and Operations, owning the project plan (milestones and OKRs), managing vendors, guiding cross-functional decisions and proactively mitigating project risk.  This entails working closely with external vendors, internal product managers and engineering teams. 

The focus of this work is to assure that we have high-quality reliable and scalable data flows from standard HIT systems (ranging from claims to clinical results to EHR data elements), maximizing the use of existing and emerging (FHIR API) health data standards.

As a Senior Manager of Interoperability, you will:

  • Lead several interoperatiliby programs for Clover driven by clinical leadership, aligning with product and engineering priorities, leading cross-functional teams to support plan operations and products to market. Be responsible for reporting and ensuring success metrics and quickly fine-tuning the program as needed.
    • Manage clinical data acquisition and interoperability efforts throughout the project lifecycle and provide the cross-functional coordination and inter/intra team communications necessary for successful completion.
    • Act as a thought partner to continually evolve the interoperability strategy based on company objectives, market and technology trends, federal/state policy and regulatory developments, etc.
    • Provide the required hands-on health IT software project management, cross-functional coordination, and inter/intra team communications to deliver outstanding program outcomes.
    • Take responsibility for release/program schedules and milestones, keeping up a high velocity in a fast-paced environment.
  • Provide the required project management, cross-functional coordination, and inter/intra team communications to deliver outstanding program outcomes. Be a key subject matter expert on interoperability with Product, Design, and Engineering teams to help design/implement strategies. Determine and define clear deliverables, roles and responsibilities for project members. 
  • Work closely with external vendors, software engineers, product managers and other stakeholders to get high-quality clinical data and features through the software project lifecycle (build, test and release on time).
    • Manage interoperability specifications with clinical data exchange partners (e.g., provider groups/practices, hospitals, ancillary service providers, health information organizations, etc.) and third-party vendors.
    • Plan and develop requirements and standards in reference to integration projects.
    • Manage project schedules, support collaborative work with external vendors, identify and troubleshoot data management issues, clearly communicate them to project stakeholders and support mitigation and resolution of issues.
  • Develop and implement procedures, processes, etc. to monitor the ongoing exchange between Clover and its partners to ensure data quality (timeliness, completeness, accuracy, validity); and work with internal/external stakeholders to resolve operational issues as needed.
    • Collaborate with other Clover teams to acquire and consume clinical data necessary to support Clover programs and functions, such as Quality Reporting, Risk Adjustment, Utilization Management, etc.
  • Provide subject matter expertise to help engineers understand HIT source systems and translate clinical requirements into specifications that assure that our applications provide timely, accurate and actionable information to clinical end-users.

You will love this job if:

  • You love bridging the gap between traditional health tech and enabling the development of  technical tools to solve business problems and thrive on creating value.
  • You are comfortable talking about clinical system matters with both technical and clinical people and driving to solve common problems and issues. Be able to express how company implementation goals can be addressed leveraging our interfaces/interactions with traditional health care IT systems..
  • You have a knack to craft clear communications to support aligned efforts for successful implementation--including clinical system end-users. Ability to act as the translation bridge between traditional health IT, new Clover tech and operational business priorities.
  • You aspire to build successful implementation program management outcomes from idea to launching programs in multiple contexts throughout your career.
  • You are passionate and driven by Clover's mission. You're excited to create a significant impact on member experience and the business.

You should get in touch if:

  • You have 5+ years of healthcare industry experience in health IT system implementation, including a focus on clinical data.
  • You have experience with end-user training of a SMART on FHIR App (Standalone or EHR launch).
  • You have experience working with API Security Standards and Implementations (Oauth 2.0, Open ID etc).
  • You have experience working on SMART App Launch framework, Launch from EHR and Launch Sequence.
  • You have experience in developing REST API with different formats JSON, HTML etc.
  • You have a strong hands on knowledge of HL7 2.x, FHIR (r2-4), CDA, SNOMED, ICD 10, FHIR Resources, 21st Century Cures Act and experience interfacing with widely used EHRs (Epic, Cerner, Athena, Greenway, eClinicalWorks, Practice Fusion, and AllScripts), HIEs, and Interface Vendors (eg.Redox) or Engines (Mirth, Cloverleaf).
  • You have experience working with operations, engineering, product and data science teams.
  • You have experience as a program/project implementation manager of health IT systems.
  • You have domain knowledge in clinical information and/or medical claims/practice management systems.
  • You are familiar with FHIR interoperability standards and reference implementation approaches.
  • Bonus Points: You have a BS degree in Computer Science, Engineering, Mathematics, Statistics, related fields or equivalent practical experience.

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.

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.