Clover Health

Recruitment

• Own full-cycle recruiting for People Operations and Corporate roles from intake through offer
• Build target company lists and market maps for priority searches
• Research culture, structure, and organizational dynamics at target companies and document findings
• Identify strong candidates, including passive candidates not actively seeking employment
• Represent Clover's mission and business complexity accurately to candidates
• Run leadership searches with retained-search rigor and discretion
• Direct AI tools across sourcing, research, outreach, and pipeline management
• Partner with the Chief People Officer and Head of Recruiting on calibration and slate quality
• Keep hiring managers and the recruiting team informed about market conditions, candidate sentiment, and pipeline health
• Fill numerous Corporate roles, including at least one leadership search, within six months
• Establish reusable talent maps and make market mapping and proactive sourcing standard practices

Senior Recruiter, Corporate

Customer Success Manager

• Serve as a strategic advisor to primary care organizations in New Jersey using Counterpart Assistant
• Own the success strategy and performance of a complex portfolio of provider partnerships
• Establish shared clinical, operational, and business objectives with provider and practice leaders
• Monitor adoption, engagement, provider satisfaction, clinical opportunities, retention risks, and expansion potential
• Anticipate barriers and intervene early to protect partner value and account health
• Lead business and performance reviews that translate data into priorities, decisions, and commitments
• Build trusted relationships with physicians, advanced practice clinicians, practice administrators, and executive stakeholders
• Advise on incorporating Counterpart Assistant into clinical decision-making and value-based care operations
• Tailor recommendations to organizational workflows, patient populations, staffing models, technology environments, and performance goals
• Lead sensitive conversations involving performance gaps, resistance to change, competing priorities, and partnership risk
• Diagnose workflow challenges and design solutions embedding Counterpart Assistant into daily clinical operations
• Guide practices through implementation, change management, training, workflow redesign, and ongoing optimization
• Establish adoption plans with milestones, ownership, success measures, and escalation paths
• Analyze utilization, operational, clinical, and financial data to identify trends, risks, and opportunities
• Deliver actionable scorecards and recommendations to improve value-based care outcomes
• Lead interventions for underperforming practices and evaluate impact
• Develop scalable provider-success playbooks, tools, and engagement models
• Lead cross-portfolio initiatives improving implementation quality, adoption, retention, or provider experience
• Recommend product, operating-model, and go-to-market improvements using market insights and provider feedback
• Represent Provider Success in strategic cross-functional initiatives and planning discussions
• Collaborate with Growth, Implementation, Clinical, Product, Analytics, and Operations teams
• Support provider recruitment and expansion opportunities as a product, workflow, and value-based care expert
• Translate provider feedback into insights informing product priorities and operational decisions
• Lead complex escalations by aligning teams around root causes, owners, and action plans
• Mentor Provider Success colleagues and contribute to team standards, tools, and capabilities

Senior Provider Success Manager

Manager

• Execute the national provider success strategy to achieve regional performance goals
• Own regional outcomes, including provider satisfaction, engagement, retention, and issue resolution
• Drive increased adoption and sustained use of Counterpart Assistant across assigned markets
• Apply national playbooks and workflows while tailoring execution to local provider and market needs
• Lead, coach, and develop regional provider success teams, including Regional Directors of Operations and Account Managers
• Build and maintain executive-level relationships with key provider partners
• Coach teams to define account-level tactics, prioritize daily work, and deliver against regional goals
• Own regional staffing, prioritization, and resource allocation decisions
• Identify workflow, implementation, and operational barriers unique to individual practices or markets
• Develop and execute local tactics to remove blockers and improve provider experience
• Monitor regional performance trends, risks, and opportunities
• Escalate systemic issues and insights to national leadership for enterprise-level resolution
• Partner with regional Clinical, Network, Growth, and Operations leaders to ensure coordinated execution

Senior Manager, Provider Success

Technical Recruiter

• Own full-cycle recruiting for a subset of Clover's technology teams
• Partner with hiring managers to understand role scope and business needs
• Build effective job descriptions, hiring/interview plans, and targeted sourcing strategies
• Track, analyze, and share pipeline and performance data with hiring teams and internal recruiting partners
• Facilitate decision-making and advise on roadblocks with recommended solutions
• Enhance the Clover talent brand to attract top talent
• Develop creative sourcing tactics to engage passive candidates and increase pipeline diversity
• Use market intelligence and funnel metrics to inform search strategy
• Build trusting relationships with leaders and hiring managers
• Serve as the first point of contact with prospective candidates and pitch Clover and hiring teams
• Support Counterpart Health for a six-month engagement

Contract Technical Recruiter

Implementation Specialist

• Lead customer-facing implementation of Counterpart Assistant for new provider practices and TINs from late-stage prospect through successful launch
• Partner with account management to hand off new customers and own the customer relationship through implementation
• Independently lead multiple concurrent implementations and cross-functional launch work
• Serve as primary contact for technical implementation from project kickoff through post-go-live steady state
• Lead end-to-end project plans, aligning internal and customer teams on scope, timeline, and status
• Partner with account management, support, product, and engineering to unblock issues and coordinate handoffs
• Surface risks, drive resolution, and hold launches accountable to target dates and quality standards
• Monitor and address potential integration issues with product and engineering
• Define and refine implementation playbooks, tooling, and templates
• Capture customer feedback and pain points for product, engineering, and support improvements

Implementation Manager

Medical Reviewer

• Conduct scheduled and ad hoc peer-to-peer discussions with treating physicians and other qualified providers regarding inpatient, outpatient, post-acute, and other authorization requests
• Review members' clinical documentation, utilization management review, applicable criteria, and rationale for proposed or issued determinations
• Evaluate medical necessity and the appropriate level of care, including inpatient versus observation/outpatient status
• Apply CMS Medicare Advantage requirements, the Two-Midnight benchmark, applicable NCDs/LCDs, MCG or other approved clinical criteria, and health plan policies
• Discuss clinical rationale for determinations with treating providers
• Consider additional clinical information and determine whether it changes the medical necessity determination
• Approve or overturn proposed adverse determinations when supported by new information, within delegated authority and organizational policy
• Escalate complex, high-risk, or unclear cases to Medical Directors or clinical leadership
• Document P2P discussions accurately and contemporaneously
• Complete P2P requests within regulatory and organizational turnaround times
• Identify recurring clinical, documentation, criteria, or provider-education opportunities and communicate trends to UM leadership
• Collaborate with nurses, medical directors, appeals and grievances, provider engagement, and other operational teams
• Maintain confidentiality and comply with HIPAA, CMS, accreditation, and organizational requirements
• Lead case review discussions on clinical JOCs

Physician Advisor – Medical Reviewer, 1099 Contractor

Pharmacist

• Create, manage, and respond to cases and escalate to Clinical Pharmacists as needed
• Support Medicare Part D Star measures by resolving medication management problems and providing recommendations based on profile review or patient interview
• Represent the Pharmacy team in cross-functional meetings
• Collect and present PBM delegated-function data and trends to propose process improvements
• Deliver cross-functional initiatives and ad-hoc projects
• Provide guidance on pharmacy clinical and regulatory workflows, policies, and processes
• Liaise between the PBM Account Management Team and Clover Health and escalate issues for resolution
• Organize pharmacy team meetings with internal and external partners
• Distribute work and strategize completion of quality assurance projects
• Maintain and update Part D content in the internal knowledge base
• Lead educational training on Part D knowledge and vendor platforms
• Participate in call center quality assurance reviews
• Perform strategic work to increase MTMP Star measure
• Navigate tools and platforms for task/queue-based work
• Serve as a resource to peers and complete program/project-based work
• Communicate issues to pharmacy leadership
• File, review, and validate reports for Medicare compliance
• Gather data and generate reports to improve clinical pharmacy quality metrics
• Participate in training and orientation of new team members
• Execute other assigned duties

Pharmacy Programs Specialist

Vice President

• Own the Medicare Advantage pharmacy strategy across the health plan
• Lead Clover's relationship with its PBM, including contract performance, service levels, cost management, and contractual adherence
• Develop formulary strategy balancing clinical quality, member experience, and financial performance
• Ensure PBM contractual compliance and oversight across vendor agreements and CMS requirements
• Identify macro pharmacy spend management opportunities
• Build and lead a team of pharmacy associates managing critical PBM and vendor relationships
• Partner with Finance on forecasting, rebate strategy, and pharmacy economics
• Partner with Clinical Care Services, Network, Legal, and Product leaders to maximize PBM performance and financial outcomes
• Support enterprise Part D Stars initiatives through PBM execution, contractual fulfillment, and formulary decisions
• Provide executive recommendations on emerging pharmacy regulations, market dynamics, and strategic opportunities
• Identify opportunities to improve quality, affordability, and financial performance across PBM contracts
• Build executive and PBM partner relationships, assess performance and compliance, and develop a multi-year pharmacy strategy
• Implement improvements in PBM governance and performance management
• Establish operating rhythms across pharmacy strategy, finance, legal, and care management teams