Clover Health - Senior Manager, Strategic Configuration

• By the end of your initial 90-day period: You will have conducted a deep-dive assessment of our first-pass accuracy landscape, identifying key configuration gaps in current process flows and specifically targeting opportunities for edit optimization to reduce payment variances. • By the end of your initial 90-day period: • By 6 months: You will have implemented strategic process flows and enhanced precision-based review triggers that align configuration with payment integrity and clinical review requirements. During this time, you will have established a refined "accuracy-by-design" workflow that ensures claims are adjudicated correctly during the initial pass. • Continued success: You will lead Clover toward a market-leading first-pass payment accuracy rate. By championing automated solutions and predictive modeling, you will ensure our payment ecosystem is one of the most accurate and technologically advanced in the Medicare Advantage space. • Continued success: • You should get in touch if: • You have 7+ years of experience in Medicare Advantage or healthcare plan configuration, with at least 3 years in a leadership or managerial role. • You possess "in the weeds" expertise in technical configuration, specifically regarding complex provider contracts, clinical edits, and general reimbursement logic. • You are highly proficient in health plan systems such as HealthEdge HRP and Source. • HealthEdge HRP and Source • You demonstrate strong project management and problem-solving abilities with a proven track record of driving systemic process improvements. • You are passionate about leveraging technology and data-driven insights to drive operational precision. • You have excellent verbal and written communication skills with the ability to translate complex technical concepts for diverse stakeholders.