Clover Health

Director

• Lead the development and execution of Clover’s provider network strategy in New Jersey, including maintaining network adequacy and coverage, advancing strategic growth, and directing data-driven reviews and action plans across all specialties.
• Establish and execute on an annual contracting roadmap aligned with affordability, access, and quality goals.
• Lead a team to deliver high-quality and data-driven contracting operations for PCP, specialist, ancillary and hospital entities.
• Oversee provider contracting activities, including new agreements, renegotiations, amendments, and escalations.
• Ensure CMS and state network adequacy compliance.
• Serve as the escalation point for complex provider negotiations, rate exceptions, and redline decisions.
• Implement contracting governance, including contract lifecycle management.
• Partner with Legal, Finance, Compliance, UM, and Claims to ensure operational readiness and consistency across all provider agreements.
• Ensure analytics are accurate, repeatable, and used to drive contracting priorities.
• Own provider intake governance and decision-making, and establish and monitor team SLAs for contracting throughput.
• Create and deliver Network dashboards for leadership, including key progress points, major initiatives, adequacy status, contracting pipeline and/or OON savings.
• Drive continuous improvement across workflows, documentation, and provider experience.

Director – Network Performance

Chief Technology Officer

• Be the CTO and CEO's technical complement. Handle the problems, conversations, and stakeholder relationships that would otherwise consume their time and attention.
• Listen to business stakeholders — operations leaders, department VPs, cross-functional partners — understand their pain, and scope pragmatic solutions. You are effortlessly approachable and people trust you to help.
• Ship working solutions — sometimes personally, sometimes by marshaling the right engineers, analysts, or vendors across the department. You know when to build it yourself and when to pull in the right people. Either way, you are accountable for the result.
• Exercise disciplined judgment about scope. You know the difference between a focused interim solution and a sprawling system that takes years to unwind. You build things that are easy to replace when the long-term architecture arrives.
• Manage a portfolio of tactical problems across the organization. You context-switch fluently across domains and stakeholders, keeping multiple workstreams moving without letting any of them expand beyond their mandate.
• Partner closely with the CTO to ensure interim solutions converge toward the long-term technical vision. You flag what's working, what's stuck, and what needs to graduate from "good enough" to "built right."

Principal Technologist

Full-stack Engineer

• Simplify the complexities of healthcare by building scalable systems that enhance human efforts.
• Stay up-to-date with new tools and technologies to solve challenges and advance our goals.
• Help define and maintain development best practices to enable rapid iteration while ensuring quality, including writing tests and documenting key implementations.
• Work with Product Managers and operational teams to design and develop new features.

Software Engineer

Strategy

• Fully accountable for your initiative's outcomes. Own the product strategy, technical strategy, and delivery.
• Translate high-level goals into concrete work streams with clear milestones and metrics that connect operational progress to financial impact.
• Drive system design, technology selection, and architecture decisions, including AI-forward systems. Make pragmatic tradeoffs between speed and durability, holding the line on engineering quality while keeping velocity high.
• Own delivery personally. Pull in engineers, data analysts, and other specialists as needed, but you are the one building — not managing the building of — your initiative's systems.
• Become your initiative's subject matter expert. Go deep on the business domain, user needs, operational workflows, and data landscape. Influence across teams through clarity and the expertise you cultivate.
• Design experiments, define success criteria, and use data to guide product and technical tradeoffs. Make progress legible to leadership as a byproduct of your methodology.

Principal Technologist, Strategic Initiatives

Machine Learning Engineer

• Design, implement and validate high-reliability, distributed platforms for machine learning, natural language processing, and LLMs.
• Create, debug, interpret and improve production machine learning and natural language processing models.
• Build the tools and validation processes that help Clover translate insights into action at scale.
• Use existing commercial and open-source tools to create a robust production platform.
• Work closely with Clover's Data Science and Engineering teams to ensure that the ML/NLP/LLM Platform is providing real value.
• Document, iterate, and provide tutorials to ensure Data Scientists are able to use your tools easily.

Senior Machine Learning Engineer

Data Scientist

• Lead large-scale projects from ideation through enterprise impact.
• Apply a broad problem-solving toolkit to develop both creative and practical solutions.
• Evaluate trade-offs between out-of-the-box and customized solutions, optimizing for speed and effectiveness.
• Implement scalable, bug-free, and well-tested solutions that reduce complexity rather than add to it.
• Understand business challenges and deliver results that meaningfully solve key problems.
• Proactively engage with stakeholders across all levels to align data science efforts with business needs.
• Identify and mitigate risks early, preventing roadblocks that could arise later.
• Serve as a trusted advisor and thought partner, ensuring projects are delivered on time and aligned with business objectives.
• Mentor and collaborate with peers, improving team-wide problem-solving capabilities and technical execution.

Senior Data Scientist

• Own the technical design and implementation of systems that support clinician workflows, scheduling, routing, and visit management.
• Design and build intelligent logistics infrastructure that optimizes clinician time, geography, and member risk.
• Collaborate deeply across teams (clinical operations, product, analytics, and engineering) to identify and deliver scalable technology solutions.
• Translate operational and clinical needs into robust, maintainable, production-grade systems.
• Build automation and AI-enabled workflows that reduce administrative burden and increase clinician capacity.
• Drive initiatives from technical discovery and architecture through implementation, launch, and iteration.
• Contribute to engineering best practices, system reliability, and long-term scalability.
• Help shape technical direction and influence the evolving product roadmap through systems thinking and cross-functional collaboration.

Senior Software Engineer

• Build, lead, and inspire a high-performing organization covering solutions architecture, implementation, EHR integration project management, technical account management, data operations, application support, and professional services.
• Define and own the technology delivery strategy and roadmap, ensuring seamless delivery across the full lifecycle: sales → implementation → support → ongoing success.
• Develop strategy for professional services, delivering the technology solutions and incremental support customers might need to achieve success through custom development.
• Drive execution of customer implementations with rigor, reducing implementation timelines while maintaining high reliability and customer satisfaction.
• Establish the technical account management function to proactively manage customer health, identify risks, and ensure long-term adoption and growth.
• Build a scalable data operations capability to manage customer data quality, compliance submissions, and automation.
• Partner closely with product, engineering, clinical, and go-to-market teams to ensure technology delivery is integrated with company strategy and execution.
• Operate as an executive leader in the organization: accountable for business outcomes, proactive in surfacing risks, and decisive in resolving operational blockers.
• Foster a culture of accountability, data-driven decision making, and cross-functional collaboration across all teams under your leadership.

Director, Customer Delivery

Data Engineer

• Be responsible for the monitoring and management of the end to end data flow of data submissions to vendors and government agencies to mitigate data leakage and submission errors.
• Own the claim and supplemental submission workflow for CMS EDS submissions.
• Develop data pipeline tracking reports and analyze, research, and resolve encounter data errors.
• Support the claim and supplemental submission workflow for CMS EDS submissions.
• Collaborate closely between the Engineering and Risk Adjustment teams.
• Assist with, track, and implement risk adjustment related initiatives and strategies.
• Maintain, update, and create policies, procedures, and other documentation around the encounter process.

CMS Encounter Data Engineer

Analyst

• Identify, develop, and deploy a portfolio of cost-saving concepts and initiatives that drive specific and measurable results for Clover.
• Translate individual concepts into SQL code that can be deployed in an automated fashion against Clover's pending and/or paid claims data.
• Support existing and develop new medical record review and administrative hold concepts/edits to drive specific and measurable results.
• Lead cross-functional discussions with billing experts, clinical staff, and operations managers to translate complex claims data into operational improvements.
• Train other members of the team to create SQL code for minor reporting or quick analysis.
• Support the team with daily operational tasks such as triaging Salesforce tickets, assisting with audit letter creation, and reimbursement processing.
• Influence senior leadership to adopt new policies, procedures, concepts, and initiatives to drive claims payment accuracy and medical cost containment.
• Act as a subject matter expert on all things data-related, including claims, enrollment, and clinical. Partner with data and engineering teams to investigate data issues when they intersect with payment integrity processes.
• Generate monthly, quarterly, and annual payment integrity financial reports as well as ad-hoc reports to support operational functions.

Payment Integrity Analyst

• The role applies advanced analytics, data engineering, & statistical modeling to large healthcare operational datasets to generate insights for organizational decision making.
• The employee leads the strategy, design, & optimization of an enterprise analytics platform on Google Cloud Platform, using BigQuery, Apache Beam, Airflow, Kubernetes, & Tableau.
• They oversee development of data pipelines, semantic layers, & reporting systems for BI tools including Mode, Looker, & Tableau.
• Projects focus on value-based care operations, including risk adjustment, claims analytics, quality reporting, & executive dashboards.
• The work supports providers & payers in improving outcomes & efficiency through analytics, with platforms built for operational, financial, & quality data not clinical trial or research data.
• Manage a team of data scientists, analysts, and BI developers to most effectively drive impact for our users and their patients.
• Focus on identifying and solving the highest impact analytics data platform enhancements both for our users and our business simultaneously.
• Be accountable to analytics that drive outcomes.

Director, Analytics

Recruitment

• Own full-cycle recruiting for key teams within Counterpart Health and Clover Care Services, partnering with senior leadership to design strategic hiring plans and effective job descriptions.
• Navigate the build-from-scratch environment of a scaling business unit, developing creative sourcing tactics to engage passive talent in new and existing markets, educating new hiring managers to our process and values, and increasing pipeline diversity.
• Be a strategic advisor to hiring managers, helping them understand role scope and business objectives while holding teams accountable to an equitable and rigorous interview process.
• Master the data by leveraging our tech stack to identify blockers, build performance dashboards, and provide meaningful solutions for process improvement.
• Enhance the Clover talent brand to attract top-tier candidates who are mission-aligned and eager to tackle complex healthcare challenges.
• Collaborate across People Operations on large-scale projects, helping to mentor junior team members and evolve our talent strategy.

Recruiter, Provider Engagement – Success

Data Analyst

• Gather requirements from stakeholders and translate to specific and actionable work tasks.
• Develop complex SQL queries to support data-driven insights that inform business and clinical decisions.
• Analyze healthcare data (claims, lab, pharmacy and EMR data) to draw conclusions and provide consultation to stakeholders for use in administering specific programs and operational processes.
• Develop reports, dashboards, and visualizations that provide insights into various patient populations and health care utilization patterns.
• Partner closely with clinical and operational teams to ensure data-driven decision-making and assist in the assessment of treatment concordant care.
• Analyze CCS operations relative to goals and summarize the completion of routine tasks by various business unit resources.
• Ensure data accuracy, quality, and integrity when working across multiple data sets.
• Prepare and present findings and recommendations to leadership, internal clinical teams, and external stakeholders in support of Clover Care Services business initiatives.