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Clover Health

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

Manager, Network Development and Management
Job Description / Skills Required

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

Clover Health is a Medicare Advantage and 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 and 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 and executing the network development and provider contracting strategies within the Midwest market. You will also be responsible for leading the development of the network management strategy which includes aspects of technology & product development, utilization management, value-based care, membership growth, marketing, compliance, and member and provider experience. 

As a Manager of Network Development and Management, you will:

  • Lead network development and the execution of network build strategy throughout designated markets/geographies.
  • Formulate engagement and contracting strategies to drive provider participation in Medicare Advantage, Direct Contracting and other value-based initiatives.
  • Be the face of Clover Health in engaging with local health systems and provider groups.
  • Develop and maintain mutually beneficial relationships with providers and key stakeholders.
  • Manage all associated contracting and the deployment of Clover's flagship technology platform, the Clover Assistant, to Primary Care Providers.
  • Lead all contracting negotiations with the full provider network; i.e. hospitals, specialists and ancillaries.
  • Manage full lifecycle of key health system partnerships.
  • Lead performance analysis by finding opportunities to improve networks and agreements.
  • Engage and partner cross-functionally with marketing, legal, finance/medical economics, customer success and other internal teams to support contracting and development opportunities.

You will love this job if:

  • You are an experienced negotiator and able to create win-win scenarios.
  • You are passionate about transforming healthcare delivery through data driven analysis and development of new technologies.
  • You have an insatiable curiosity which feeds an appetite to learn and teach.
  • You want to make an impact. You thrive off of helping others and 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 and positive relationships with many different types of people, teams, and partners.
  • You are nimble, and comfortable working in a constantly evolving environment. You embrace ambiguity and speed while maintaining a bias towards action.

You should get in touch if:

  • You have experience managing an assigned territory and making on-site visits to execute provider strategy and recruitment.
  • You have a strong analytical and quantitative background.
  • You have well developed leadership skills and the ability to influence, collaborate and motivate others.
  • You have experience in network management, provider contracting, and/or managed care.
  • You have a proven understanding of provider contract options, healthcare economics and competitors practices with the ability to grasp both clinical and business concepts.
  • You have experience leading and managing cross-functional teams against monthly targets and broader, strategic goals.
  • You have experience negotiating varied managed care contracts to improve overall performance; flexing details quickly based on real-time conversations.
  • You are able to create buy-in and drive action across a wide set of collaborative team members.
  • You have a great understanding of healthcare topics, such as claims processing, EHRs, medical billing and coding and physician reimbursement models.
  • MBA/MPH preferred.

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.