Clover Health (501+ Employees, 63% 2 Yr Employee Growth Rate)
Clover is reinventing health insurance by working to keep people healthier.
The Stars team at Clover collaborates with teams across operations, clinical, pharmacy, data science and technology to ensure the Stars strategy is implemented, executed, and will lead to improved performance across all measures. Stars operations are a critical barometer of the company's health, indicating how well we're helping our members achieve better health outcomes and how well we're functioning as a business.
We’re looking to hire an Operations Consultant to support all aspects of the Stars Operations team at Clover Health. The Stars team is accountable for achieving the highest possible Medicare Star rating for Clover through the successful execution of business initiatives and other strategic plans. This work is carried out through thoughtful collaboration with key stakeholders within the organization, external vendors and providers, state and federal regulators, and advocacy groups.
Responsibilities include assisting Stars leadership in maintaining, or improving, overall Star Ratings to achieve Stars goals for all contracts. This role may be assigned to lead strategy execution for specific measures or initiatives. The role will compile, collect, analyze, present data to support the Stars program including Stars strategy and Stars improvement initiatives. As part of this work, the candidate will be or become an expert around the technical specifications for the Stars program and the technical descriptions for all Star ratings’ measures.
As an Operations Consultant for Stars, you will:
- Assist in the identification, development and implementation of Stars measure improvement programs.
- Support the process of improving HEDIS through initiatives to drive rate improvements, data collection and process improvement, as well as innovative activities targeting identifying incremental data.
- Lead projects or initiatives designed to impact Stars rates, which may include managing temporary staff or coordinating activities with matrixed partners.
- Work on quality-related project teams, identifying improvements to workflows, and through the identification of operational efficiencies and best practices.
- Coordinate the development and revision of operational policies and procedures, workflows, and communications (both internal and external) in support of Clover’s Stars Program.
- Run reports from various sources; provide feedback on ways to improve reports and the analysis of reports to enhance their value to market managers and provider groups.
- Manage intake of and provide resolution or escalation for ad hoc requests or needs of market operations or health services staff.
- Assure compliance by delivering quality services and meeting all contractual, state & federal legal and regulatory requirements.
- Be forward thinking and collaborative about measuring specific improvements.
- Define critical KPIs and build core operating dashboards to manage performance related to Stars measures and initiatives.
- Understand year over year regulation changes to the Stars program and how it will affect Clover programs and product development.
- Present relevant strategies and results with analytical evidence to the executive leadership team.
You will love this job if:
- You love providing guidance and leadership to multidisciplinary project teams to deliver high quality, improvement-oriented analysis.
- You are tech and data savvy. You are used to thinking about how technology can enable better experiences and how you can use data to make better decisions.
- You know how to drive results.
- You value high trust, high ethics relationships and build/support these qualities in your working partners.
- You have and value in others strong, collaborative problem-solving skills.
- You are a seasoned critical thinker.
You should get in touch if you have:
- 5+ years of project management, organizational, research, analytical, and/or negotiation experience in a fast paced working environment.
- 5+ years of Managed care and/or other healthcare service delivery experience (strongly preferred).
- Strong bias to and proven track record of execution.
- Excellent written and verbal communication skills.
- Strong proficiency in Microsoft Office applications (Outlook, Word, Excel, Power Point, etc.), including experience running web based meetings.
- SQL or Medical record collection background (preferred).
Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records. We are an E-Verify company.
About Clover: We are reinventing health insurance by combining the power of data with human empathy to keep our members healthier. We believe the healthcare system is broken, so we've created custom software and analytics to empower our clinical staff to intervene and provide personalized care to the people who need it most.
We always put our members first, and our success as a team is measured by the quality of life of the people we serve. Those who work at Clover are passionate and mission-driven individuals with diverse areas of expertise, working together to solve the most complicated problem in the world: healthcare.
From Clover’s inception, Diversity & Inclusion have always been key to our success. We are an Equal Opportunity Employer and our employees are people with different strengths, experiences and backgrounds, who share a passion for improving people's lives. Diversity not only includes race and gender identity, but also age, disability status, veteran status, sexual orientation, religion and many other parts of one’s identity. All of our employee’s points of view are key to our success, and inclusion is everyone's responsibility.