You will design and champion internal quality programs while building SDLC observability pipelines to increase deployment velocity. Additionally, you will architect shift-left pipeline gates and leverage generative AI to automate infrastructure and testing frameworks.
Clover Health
37 Remote Job Openings at Clover Health
The Specialist Navigator serves as the primary liaison between the Network Performance team and specialist providers to drive network optimization and performance improvements. This role involves analyzing utilization data to implement strategies that enhance quality, access, and affordability within the healthcare network.
The Senior Manager of Service Operations oversees enrollment, billing, and mailroom functions while managing vendor relationships to ensure compliance and operational efficiency. They act as the primary point of contact for regulatory audits and drive cross-functional initiatives to improve member experience.
Conduct comprehensive health assessments for Medicare Advantage members remotely using telehealth technology. Coordinate care plans, document medical histories, and facilitate transitions for at-risk patients in collaboration with primary care providers.
The Senior Manager will oversee the Telesales program, managing external partners, performance metrics, and staffing to meet sales and retention goals. They will also lead technology improvements, contract negotiations, and develop strategies to optimize the inbound and outbound lead funnel.
Lead the Data Products pillar by owning the technical strategy and execution for clinical data ingestion and canonical data modeling. Manage the scaling of customer data onboarding and drive the adoption of an AI-powered software development life cycle.
Identify, engage, and enroll primary care providers into the Counterpart Health network through product demonstrations and value communication. Manage a sales pipeline and represent the brand at healthcare events to accelerate market expansion.
Lead clinical product development by serving as the primary clinical voice to ensure software reflects real-world primary care practice. Bridge the gap between clinical workflows and software design to drive clinical utility and safety for providers.
Lead the healthcare interoperability strategy and serve as the external face of the company within the industry ecosystem. Manage a team of engineers to translate complex standards into product capabilities and ensure compliance with CMS requirements.
Own the end-to-end operating model and outcomes for provider engagement and growth programs, ensuring milestones are met and risks are mitigated. Translate program performance data into concise reporting for senior leadership and manage direct outreach to healthcare providers.
Identify, engage, and enroll primary care providers into the Counterpart Health network through direct outreach and product demonstrations. Manage the sales pipeline and collaborate with Provider Success teams to ensure a seamless onboarding transition.
The role involves building and maintaining a scalable infrastructure platform using Kubernetes and automation tools to eliminate toil. Responsibilities include managing the application lifecycle, troubleshooting infrastructure issues, and streamlining delivery pipelines.
Conduct comprehensive health assessments and preventive care for Medicare Advantage members via telehealth and proprietary software. Coordinate personalized care plans with primary care physicians and manage transitions from hospital to home.
The Buyer manages the end-to-end procurement process, including sourcing, supplier selection, and commercial negotiations. They are responsible for maintaining vendor relationships and overseeing contract renewals and compliance within the CLM system.
Design and champion internal quality programs and reliability roadmaps to increase deployment velocity and reduce incidents. Architect shift-left pipeline gates and leverage Generative AI tooling to automate infrastructure and testing frameworks.
Lead end-to-end fraud investigations within the Medicare Advantage business, from intake and evidence gathering to resolution. Coordinate closely with the legal department to ensure investigations are defensible and prepare referral packages for regulatory and law enforcement agencies.
Lead and grow a global team of SREs to ensure infrastructure reliability, scalability, and cost-efficiency. Transition the SRE model from reactive support to proactive collaboration with product engineering through platform engineering and self-service capabilities.
Lead the technical strategy and execution for the Interventions pillar to improve early diagnosis and longitudinal care management of chronic conditions. Oversee the scaling of clinical data infrastructure and drive the adoption of AI-powered development workflows to increase engineering productivity.
Lead the evolution of the compensation function by integrating AI tools to automate workflows and enhance decision-making. Manage end-to-end equity programs, annual compensation cycles, and ensure compliance with SEC and tax regulations.
Own the end-to-end cloud infrastructure and SDLC surface area to enable rapid shipping and AI-native operational capabilities. Lead a small team of engineers while collaborating with SecOps and Data leaders to ensure reliability, security, and cost discipline.
Build and maintain core Value-Based Care performance metrics across risk, quality, utilization, and cost domains. Translate complex clinical and financial data into actionable narratives and dashboards for payer and provider partners.
The role serves as the Subject Matter Expert for clinical data completeness, owning the end-to-end clinical data lifecycle and monitoring data quality across various healthcare facilities. You will analyze data gaps, evaluate integration vendors, and partner cross-functionally to ensure reliable clinical data flow for the AI-powered platform.
Own the end-to-end strategy, architecture, and execution of the data platform to enable self-serve data access. Lead a high-impact engineering team while remaining hands-on in building AI-native pipelines and optimizing data warehouses.
Evaluate, configure, and deploy AI-powered tools to enhance operational efficiency across various business teams. Collaborate with cross-functional stakeholders to identify high-leverage AI opportunities and ensure secure, compliant implementation in a healthcare environment.
The Inpatient Coder Associate identifies provider DRG denials and upcoding to ensure accurate claims payments. They partner with clinical and claims teams to review inpatient services and recover overpayments.
The role focuses on the technical validation and rigorous testing of configuration logic to maximize first-pass claim payment accuracy. Responsibilities include architecting test plans, simulating real-world medical encounters, and utilizing AI tools to identify edge cases in reimbursement logic.
Lead the technical design and implementation of strategic configuration logic to maximize first-pass claim payment accuracy. Manage a lean team of specialists to optimize edit logic and integrate automated solutions while bridging gaps between configuration, payment integrity, and compliance.
Lead the strategic roadmap for claim payment precision by designing audit frameworks and maintaining clinical and reimbursement policies. Act as the bridge between technical logic and clinical intent while leveraging AI to automate monitoring and optimize vendor performance.
Own and evolve the design system by building reusable UI primitives and interaction patterns to ensure consistency across product teams. Act as the bridge between Design, Product, and Engineering to translate design intent into production-quality code.
Director, Strategic Finance (Medicare Advantage)
Clover Health
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Full Time
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3 months ago
Clover Health
Serve as the primary financial architect for the Medicare Advantage business by defining and optimizing unit economics. Lead annual planning, quarterly forecasting, and the evaluation of high-stakes strategic projects to ensure ROI.
Special Projects Manager – Innovation & Delivery
Clover Health
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Full Time
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3 months ago
Clover Health
The Special Projects Manager will drive high-priority cross-functional initiatives by translating strategic goals into structured workplans and actionable timelines. They will own critical workstreams, manage dependencies, and build operational cadences to ensure project visibility and effective execution.
The Senior Actuarial Analyst will maintain CMS HCC/RxHCC models, support monthly revenue accruals, and develop automated tools to improve actuarial efficiency. They will also collaborate with cross-functional teams to provide strategic insights on risk adjustment, pricing, and long-term growth.
Director, Governance, Risk, and Compliance (GRC)
Clover Health
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Full Time
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4 months ago
Clover Health
The Director of GRC will define and execute the enterprise security governance and risk strategy while ensuring regulatory compliance for a technology-enabled healthcare company. This role involves managing third-party risk, overseeing incident response governance, and influencing cross-functional teams to maintain a robust security posture.
You will collaborate with clinicians and product managers to build and scale healthcare systems using AI-native development practices. You are expected to take full ownership of technical solutions from problem conceptualization through delivery and measurement.
The Senior Software Developer will collaborate with cross-functional teams to build scalable, efficient systems that simplify healthcare complexities and enhance human efforts. This includes defining and maintaining development practices, writing tests, documenting implementations, and conceptualizing new features with product managers.
The Senior Software Engineer will collaborate with cross-functional teams to build scalable, efficient systems that simplify healthcare complexities and enhance human efforts. Responsibilities include defining and maintaining development practices, writing tests, documenting implementations, and conceptualizing new features with product and operational teams.
The Senior Machine Learning Engineer will design, implement, and validate high-reliability, distributed platforms for machine learning, natural language processing, and LLMs. This role involves creating, debugging, and improving production models while building tools to translate data insights into scalable action.