Clover Health

Director, Network Operations

Remote - USA · Director

Sponsorship not specified$150k-$195kDetected 20 days ago

Data EngineeringLLMsComplianceLeadershipCollaborationMentoring

About the role

As a Medicare Advantage plan, we aim to empower our members by helping them navigate the complexities of healthcare and live healthier lives.
In this high-impact leadership role, you will champion a culture of "Data Integrity at Scale," serving as the enterprise authority on Provider Data Management (PDM)-which is a critical focus area for our organization.
While leading a high-performing remote workforce, you will act as the strategic bridge between advanced data platforms, external vendors, and internal operational areas.

You will have successfully completed the directory quality audit and implemented systemic data enhancements to deliver a tangibly improved directory experience.
You will own the optimization of our PDM infrastructure, drive continuous improvement in directory accuracy, and provide rigorous oversight for our third-party credentialing and BPaaS partners.

You will have gained foundational proficiency with our core credentialing, PDM, and network adequacy software platforms, alongside our foundational AI tools.
You are a deep Subject Matter Expert in Provider Data Management (PDM), with a proven track record of transforming complex data infrastructures into highly efficient, automated systems.
You are exceptionally AI- and data-forward -you are passionate about deploying LLMs (Claude, Gemini, ChatGPT) and advanced technical solutions to replace manual workflows.
You are a master of cross-functional influence, capable of stepping into complex, multi-departmental environments to realign priorities and push stalled initiatives across the finish line.

Employee Stock Purchase Plan (ESPP) offering discounted equity opportunities
Reimbursement for office setup expenses
Monthly cell phone & internet stipend
Paid parental leave for all new parents
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.
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.
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.
Final pay is based on several factors including but not limited to internal equity, market data, and the applicant's education, work experience, certifications, etc.
At Clover Health, we're focused on improving the health of our members by leveraging technology and data-driven insights to provide personalized, high-quality care.
We are passionate about making healthcare easier, more affordable, and more accessible for everyone.

We are an E-Verify company.
We are looking for an AI-forward Director of Network Operations to architect the strategic roadmap for our provider data ecosystem, credentialing frameworks, and network adequacy models.

We are an Equal Opportunity Employer and our employees are people with different strengths, experiences, perspectives, opinions, and backgrounds, who share a passion for improving people's lives.

This listing is sourced directly from Clover Health's careers page and normalized into a canonical job model.