Operations

• Lead and oversee Clover Health’s HEDIS abstraction and submission processes, ensuring timely and accurate execution.
• Manage a team of abstraction experts
• Partner with analytics and technical teams to ensure data quality supports numerator capture, exclusions, and supplemental data submission.
• Serve as the company’s subject matter expert for HEDIS specifications, auditor engagement, and measure interpretation.
• Develop and refine processes to maximize numerator hits, manage exclusions, and ensure correct denominator definitions for all measures.
• Ensure operational readiness for HEDIS audits, including preparation, submission accuracy, and remediation processes.
• Collaborate cross-functionally with clinical and operational leaders to close gaps and translate abstraction into improved Stars performance.
• Drive daily accountability to outcomes, ensuring abstracted results translate into measurable gains in HEDIS and Stars.

Senior Director, HEDIS Operations

Radar Operations Engineer

Supplier Quality Engineer – Industrialization

Supplier Quality Operations Engineer

Senior Manager, Operations – Connectivity Solutions

Supervisor, Mid Revenue Cycle – Integrity Operations Coding Denials