Provider Engagement Associate

Benefits

Additional Information

At Clover Health, we are committed to providing high-quality, affordable, and easy-to-understand healthcare plans for America's seniors. We prioritize preventive care while leveraging data and technology through the Clover Assistant, a powerful tool that helps physicians make informed health recommendations. By giving doctors a holistic view of each member's complete health history, we ensure better care at a lower cost-delivering the highest value to those who need it most. As a Provider Engagement 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 Engagement 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. This role may require occasional travel to support onsite meetings, provider visits, company events, training opportunities, and other business needs. 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 30 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 90 days, 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. Addi

Your Match

How well this role fits your profile.

Company Intel

What employees say

Worked at Clover Health? Share your experience