Senior, Clinical Transformation Associate

Full Time
Jersey City, NJ
Posted
Job description

Clover is reinventing health insurance by working to keep people healthier.

We value diversity — in backgrounds and in experiences. Healthcare is a universal concern, and we need people from all backgrounds and swaths of life to help build the future of healthcare. Clover's Value Based Care team is responsible for the development and implementation of programs to support the growth and long term success of our Direct Contracting / ACO REACH initiative and other value based agreements.

We are hiring for a (Senior) Clinical Transformation Associate who will report to the Sr. Manager of Clinical Transformation and support the implementation and success of clinical initiatives across a subset of Clover's ACO network.

As a (Senior) Clinical Transformation Associate, you will:

  • Support the Sr. Manager of Clinical Transformation by working directly with 3 or more assigned large group practices/conveners to assess current state, share performance reporting, design work plans for initiatives to move up the maturity scale, guide process improvement implementations, and guide care management program implementation to impact total cost of care and quality outcomes.
  • Serve as the key point of contact for assigned large group practices/conveners, taking in all issues and ensuring issue resolution by leveraging operations specialists, and other value based care team members.
  • Lead monthly JOC meetings with each large group practice/convener arranging for support from analytics, medical directors, CMO, Sr. Manager Clinical Transformation, etc.
  • Provide standardized update reporting to support the Sr. Manager Clinical Transformation to the CMO and Sr. Leadership team on large group practice/convener performance, return to green plans, and initiatives progress/barriers, and projected time to complete the next step in the maturity model.
  • Be directly accountable for achieving MCR targets for assigned group practices.

You will love this job if:

  • You are service oriented — you feel fulfilled in helping and supporting others to achieve common goals and resolve issues.
  • You are a team player. You enjoy partnering with others, and want to work collaboratively to find new solutions.
  • You are a strong communicator. You have strong verbal and written communication skills that foster trust, knowledge sharing, and progress.
  • You are detail-oriented. You pay attention to the small things, while understanding how they fit into the bigger picture.
  • You have a bias to action and love to move quickly from ideas to execution.
  • You use analytical input to solve complex problems.
  • You are curious. You like to do research when you don't know an answer. You ask the hard questions and you don't sweep problems under the rug.

You should get in touch if:

  • You have 3+ years of Medicare healthcare experience, ideally in value-based care.
  • You have 1+ years of experience supporting clinical and provider engagement
  • Knowledge in AWV (Wellness visits) and/or TCM (Care Management) and/or Care Management.
  • Knowledge of ICD-10 preferred
  • Experience in process improvement
  • Advance in Excel and G-suite experience
  • Experience in Salesforce or other CRM -Preferred
  • Working in an Agile environment-Preferred
  • You have a keen understanding of healthcare topics, such as EHRs, clinic workflows, care management, population health, medical billing and coding and physician reimbursement models.
  • You have a working understanding of healthcare topics, pertaining to providers, such as, population health, value-based care, quality metrics, physician reimbursement models, data sharing in provider partnerships, and PCP engagement.
  • You have a basic understanding of provider contract options, healthcare economics and competitors' practices with the ability to grasp both clinical and business concepts.
  • You have strong project management or administrative skills and can multi-task while being highly organized and thorough.
  • You are able to create buy-in and drive action across a wide set of collaborative team members.
  • You have a proven ability in using data to inform decision-making as part of a broader, strategic set of goals.
  • You are able to regularly identify opportunities to implement efficient process/operational improvements.

#LI-Remote

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.

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