Medicare Advantage Plan COO

Clover Health is a physician enablement company committed to bringing access to great healthcare to everyone on Medicare.

We are seeking a highly skilled and experienced Chief Operating Officer (COO) to lead our Medicare Advantage (MA) health plan operations, reporting to our MA CEO. This position plays a critical role in optimizing our Business Process as a Service (BPaaS) model, driving operational excellence, and ensuring the efficient delivery of high-quality healthcare services to our beneficiaries. We are looking for a dynamic leader who can balance strategic thinking with hands-on operational involvement while managing complex vendor relationships.

As Medicare Advantage Plan COO you will:

• Accountable for internal and BPaas operations team delivering upon CMS requirements and enhancing business processes and capabilities for Clover’s MA plan.
• Extract maximum efficiency from our Business Process as a Service (BPaaS) model. Identify areas for process optimization and implement strategies to streamline operations.
• Develop and communicate clear operational goals and objectives aligned with the company's mission and strategic vision.
• Lead the organization in achieving operational milestones and key performance indicators.
• Foster a culture of productivity and continuous improvement within Clover’s internal team. Develop and implement strategies to maximize employee efficiency and effectiveness.
• Own and manage the relationship with BPaaS vendors, ensuring compliance, performance, and cost-effectiveness. Collaborate with vendors to drive innovation and operational improvements.
• Be an exceptional leader, inspiring and motivating the team while also engaging in detailed discussions of operational processes, dashboards, and status updates when necessary.
• Leverage your strong financial acumen and understanding of the tradeoffs between growth and profitability to assist in monitoring and managing the financial health of the MA line of business and to identify opportunities for cost control and revenue growth.

You will love this job if:

• You are highly organized and logistically-minded. You don’t shy away from complex problems.
• You are a strategic prioritizer and able to identify where and when to focus your and your team’s energy.
• You have a critical and analytical mindset. You understand how all the components of a process fit together and believe in the value of making data-driven decisions; you continuously monitor the efficacy of your programs through metrics tracking.
• You are adaptable and agile when navigating complex and evolving challenges.
• You embrace ambiguity while always maintaining a bias towards action.

You should get in touch if:

• You have a strategic understanding of Medicare Advantage plans along with 10+ years successful business leadership experience in managed care operations.
• You are able to design and develop successful operating models and you have demonstrated experience managing relationships with and optimizing performance of BPO/BPaaS vendors.
• You have proven experience leading and driving fixes and regulatory changes with operations and technical partners; business requirements, prioritization, ROI management.
• You are very resourceful and can balance strategic thinking with hands-on operational involvement. You have proven experience driving initiatives and executing on goals and strategies while maintaining high level day-to-day operations.
• You are competent in big-picture visualization, critical thinking and sequencing, (i.e., the ability to envision the product of complex business goals and work backwards to ensure all of the requisite steps and details are covered for successful achievement).

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.