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Senior Manager, Service Operations

22 hours, 50 minutes ago
United States
Full-time
Senior
Operations Manager
Customer and Technical Support
Apply Now
Clover Health

Clover Health

Clover Health is a data-focused health insurance company that is revolutionizing the Medicare Advantage space by integrating innovative technology into its plans. With a focus on optimizing medical outcomes and reducing costs, Clover Health uses analyt...

Insurance
251-1K
Founded 2014
$925M raised
View All Jobs 23

Description

  • Manage enrollment and billing operations to ensure applicant and member information is processed accurately, timely, and compliantly.
  • Oversee monthly premium billing, late enrollment penalties, and application of external subsidies such as Low Income or SPAP.
  • Direct incoming mailroom activities, including scanning, sorting, and routing mail to the correct business units.
  • Serve as the point of contact for regulatory requirements, including Medicare Program Audits, One Third Financial Audits, and Quarterly CMS Attestations.
  • Develop, maintain, and enforce organizational policies across Clover and the BPaas organization.
  • Manage day-to-day relationships and communications with the BPaas vendor.
  • Lead routine calls with the vendor and gather updates to improve meeting efficiency.
  • Align the vendor and plan on expectations, performance, and release or delivery timelines.
  • Partner with leadership and team members to develop audit and oversight plans.
  • Hold internal teams and vendors accountable to deadlines, deliverables, and remediation plans, escalating issues as needed.
  • Research, track, and resolve vendor issues, incidents, change requests, and tickets across multiple platforms.
  • Review processes and recommend improvements or remediation actions.
  • Monitor vendor performance against SLAs and CMS requirements and maintain performance scorecards.
  • Develop and track work plans, operational objectives, and resource assignments to ensure tasks are completed.

Requirements

  • 3+ years of vendor/BPaas management and oversight experience.
  • 5+ years of Medicare mailroom or enrollment and billing experience.
  • Strong communication skills with experience building and maintaining professional relationships.
  • Ability to multitask effectively in a fast-paced operational environment.
  • Ability to interpret reports and dashboards and create presentations and diagrams.
  • Experience with regulatory compliance and CMS-related requirements is required.
  • Experience working cross-functionally with internal operations teams is preferred.
  • Final pay may vary based on internal equity, market data, education, work experience, and certifications.

Benefits

  • Competitive base salary of $129,200-$168,000 USD.
  • Equity opportunities, including an Employee Stock Purchase Plan (ESPP).
  • Performance-based bonus program and 401(k) matching.
  • Comprehensive medical, dental, and vision coverage.
  • Remote-first work culture with flexibility.
  • Generous flexible time-off policy and monthly company holidays.
  • Mental health resources and No-Meeting Fridays.
  • Learning programs, mentorship, professional development funding, and regular feedback.
  • Paid parental leave for all new parents.
  • Office setup reimbursement and monthly cell phone/internet stipend.

Interested in this position?

Apply directly on the company website

Apply Now

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