Teams at Clover Health

Serve as the primary liaison between Network Performance and specialist providers to translate analytics into provider action. Drive specialist optimization, contract development, data-driven provider engagements, KPI tracking (utilization, referral patterns, ASC use), and collaborate with Analytics, Clinical, and Network teams to improve quality, access, affordability, and network performance.

Lead the evolution of claims payment accuracy by optimizing strategic configurations, managing a small team, and implementing automated solutions to enhance operational efficiency in healthcare plans.

The Senior Strategic Configuration Analyst will validate and test configuration logic for Medicare Advantage claims, ensuring payment accuracy and compliance with CMS regulations. Responsibilities include designing test plans, analyzing defects, managing testing environments, and supporting AI-enabled testing frameworks.