Medicare Advantage Enrollment Senior Associate id-6215
About the position
At Clover Health, we are committed to providing high-quality, affordable, and easy-to-understand healthcare plans for America’s seniors. We prioritize preventive care while leveraging data and technology through the Clover Assistant, a powerful tool that helps physicians make informed health recommendations. By giving doctors a holistic view of each member’s complete health history, we ensure better care at a lower cost—delivering the highest value to those who need it most. The Membership team is dedicated and enthusiastic individuals working at the heart of Medicare Advantage operations. This team maintains the business function of our Enrollment and Billing activities, including ensuring accuracy and timeliness of enrollment applications, maintaining compliance with the Centers for Medicare & Medicaid Services (CMS), researching and resolving escalated issues, and ensuring accurate member data throughout the member's journey with Clover.
Responsibilities
- Serve as the Subject-Matter Expert (SME) in daily operational and AEP readiness, as well as quality assurance activities.
- Improve the productivity of Clover's enrollment function through strong organizational skills and operational oversight of the delegated Business Process as a Service (BPaaS) vendor.
- Oversee and maximize the relationship with our BPaaS vendor through driving day-to-day interactions.
- Ensure adherence to Service Level Agreements (SLAs) and compliance with CMS regulations and Clover's internal policies and procedures.
- Work autonomously and be motivated to meet and exceed expectations.
- Develop relationships, own communications, and drive day-to-day interactions with the BPaaS team.
- Actively participate in routine calls with the BPaaS and maximize team efficiency by gathering all updates prior to calls and meetings.
- Manage the end-to-end annual readiness activities to include Annual Enrollment Period (AEP) and MA Open Enrollment Period (OEP).
- Partner with team members to develop and execute audit and oversight plans, to include SOX controls.
- Hold BPaaS and/or internal resources accountable to deadlines, deliverables and remediation plans.
- Research and address issues with the BPaaS. Track and trend incidents, change requests and other tickets across multiple platforms.
- Analyze processes and provide recommendations for improvement or remediation of issues.
- Analyze vendor performance in comparison with SLAs and CMS requirements. Develop and maintain vendor performance dashboards.
- Develop and track work plans and assist in establishing operational objectives.
Other Jobs You May Be Interested In
Remote Data Entry, No Experience, $40/hr, Part-Time
Virtual Assistant, $45/hr, Remote, No Experience, Night Job
Entry-Level Remote Data Entry, $50/hr, Evening Job
Customer Support, No Degree, $40/hr, Remote, Weekend Job
Remote Phone Job, $42/hr, Part-Time, College Student Friendly
Virtual Assistant, $40/hr, Remote, No Degree, Night Job
Part-Time Data Entry, $45/hr, Remote, College Student Friendly
Remote Moderator, No Degree, $50/hr, Evening, Weekend Job
Remote Customer Support, $42/hr, Night Job, No Experience
Live Chat Support, $40/hr, Remote, Entry Level, Part-Time
Virtual Assistant, Remote, $42/hr, Weekend, No Experience
Remote Data Entry, $45/hr, No Degree, Night Shift
Part-Time Customer Support, $40/hr, Remote, College Student
Remote Live Chat, $50/hr, Part-Time, Evening/Night Job
Entry Level Phone Job, $42/hr, Remote, No Degree Required
Weekend Data Entry, $45/hr, Remote, No Experience
Remote Virtual Assistant, $40/hr, Evening, Part-Time Job
Remote Moderator, $42/hr, Part-Time, Weekend, No Degree
Data Entry, $45/hr, Remote, Night Shift, College Student Job
Phone Support, Remote, $50/hr, No Experience, Part-Time
Virtual Assistant, No Experience, $42/hr, Remote, Weekend
Remote Customer Support, $45/hr, Part-Time, College Student
Data Entry, Remote, $40/hr, Night Shift, No Degree
Evening Virtual Assistant, Remote, $45/hr, No Experience
Weekend Customer Support, $42/hr, Remote, College Student
Remote Data Entry, $50/hr, No Experience, Evening/Night Job
Remote Live Chat, $40/hr, Part-Time, No Degree Required
Virtual Assistant, $42/hr, Remote, Weekend, Entry Level
Remote Phone Support, $45/hr, Evening, No Experience Required
Data Entry, No Experience, $50/hr, Remote, College Student
Remote Moderator, $40/hr, Weekend, No Degree, Part-Time
Live Chat Support, Remote, $42/hr, Night Shift, College Student
Phone Job, $50/hr, Remote, No Degree, Part-Time, Weekend
Data Entry, $45/hr, Remote, Evening, No Experience Required
Virtual Assistant, No Experience, $42/hr, Remote, Part-Time
Remote Customer Support, $50/hr, Night Shift, No Degree
Remote Data Entry, $40/hr, College Student Friendly, Part-Time
Live Chat Support, $42/hr, Weekend, Remote, No Degree
Virtual Assistant, Remote, $45/hr, Evening, No Experience
Remote Phone Job, $50/hr, College Student, Night Shift
Remote Moderator, $42/hr, Weekend, No Experience Required
Data Entry, No Degree, $45/hr, Part-Time, Remote Job
Customer Support, $50/hr, Remote, Evening/Night Job, No Degree
Virtual Assistant, $42/hr, Remote, Weekend, No Degree
Remote Live Chat, $45/hr, College Student, No Experience
Remote Data Entry, $40/hr, Part-Time, No Degree Required
Phone Support, $50/hr, Weekend, Remote, No Experience
Virtual Assistant, $42/hr, Evening, Remote, No Degree
Remote Customer Support, $45/hr, No Experience, Part-Time
Data Entry, $50/hr, Night Job, No Degree, Remote
Remote Moderator, $40/hr, College Student Friendly, Part-Time
Virtual Assistant, Remote, $42/hr, Weekend, No Experience
Remote Phone Job, $45/hr, Part-Time, No Degree Required
Customer Support, $50/hr, Night Job, Remote, No Experience
Data Entry, Remote, $42/hr, Evening Job, No Degree
Live Chat Support, $45/hr, Weekend, Remote, College Student
Virtual Assistant, Remote, $50/hr, Part-Time, Night Shift
Data Entry, $40/hr, No Experience, Remote, Weekend Job
Remote Phone Job, $45/hr, No Degree, College Student Friendly
Customer Support, $42/hr, Remote, Evening, No Experience
Virtual Assistant, $50/hr, Weekend, No Degree, Remote
Remote Data Entry, $40/hr, Part-Time, College Student Job
Phone Support, Remote, $42/hr, Evening/Night Shift
Virtual Assistant, No Degree, $45/hr, Remote, Part-Time
Live Chat Support, $50/hr, Remote, No Experience Required
Remote Moderator, $42/hr, College Student, Weekend Job
Data Entry, $45/hr, Remote, Night Job, No Degree
Virtual Assistant, $50/hr, Remote, Part-Time, Evening Job
Remote Customer Support, $42/hr, Weekend, No Experience
Phone Job, $45/hr, Remote, Night Shift, No Degree
Remote Live Chat, $50/hr, College Student, No Experience
Data Entry, $40/hr, Part-Time, Remote, Weekend Job
Virtual Assistant, $42/hr, Remote, No Experience, Evening
Remote Phone Support, $45/hr, Night Job, College Student
Remote Moderator, $50/hr, No Degree, Weekend, Part-Time
Virtual Assistant, $40/hr, Remote, Night Shift, No Experience
Customer Support, $42/hr, Remote, Part-Time, No Degree
Remote Data Entry, $45/hr, Weekend Job, College Student
Phone Support, Remote, $50/hr, No Experience, Night Shift
Virtual Assistant, $42/hr, Evening, Remote, College Student
Live Chat Support, $45/hr, Part-Time, Remote, No Degree
Data Entry, $50/hr, Remote, Evening Job, College Student
Virtual Assistant, $40/hr, Weekend, Remote, No Experience
Remote Phone Job, $42/hr, Night Shift, College Student Friendly
Remote Customer Support, $45/hr, No Degree, Evening Job
Virtual Assistant, $50/hr, Part-Time, Remote, Weekend Job
Data Entry, $40/hr, Evening Job, No Experience, Remote
Remote Live Chat, $42/hr, Weekend, No Degree, Part-Time
Virtual Assistant, $45/hr, No Experience, Remote, Night Job
Phone Job, $50/hr, Remote, Part-Time, College Student
Remote Data Entry, $42/hr, Evening/Night Job, No Experience
Remote Moderator, $45/hr, No Degree, Weekend Job, Part-Time
Live Chat Support, $50/hr, Remote, Night Shift, No Degree
Virtual Assistant, $40/hr, Weekend, College Student, Remote
Remote Phone Job, $42/hr, Part-Time, No Experience Required
Remote Data Entry, $45/hr, No Degree, Weekend, Night Job
Virtual Assistant, $50/hr, Evening, Remote, College Student
Customer Support, $42/hr, Weekend Job, Remote, No Degree
Phone Support, $45/hr, Remote, No Experience, Evening Job
Data Entry, $50/hr, Night Shift, No Degree, Remote Job
Requirements
- 3–5 years of Medicare Advantage enrollment and billing experience.
- Thorough understanding of the Medicare Lifecycle and deep knowledge of Medicare enrollment guidelines.
- 1–3 years of delegated vendor oversight experience.
- Ability to effectively multitask and create and decipher reports/dashboards.
- Advanced Excel/G Sheet user with knowledge of formulas and functions such as vlookup, concatenate, countif, conditional formatting, and data validation.
- Self-motivated with a desire to learn and resolve issues.
- Curious and inquisitive, seeking to root out details and nuance when analyzing issues or data.
- Comfortable working autonomously as well as cross-functionally.
- Strong communicator with proven experience developing and maintaining professional relationships.
Benefits
- Competitive base salary and equity opportunities.
- Performance-based bonus program.
- 401k matching.
- Comprehensive medical, dental, and vision coverage.
- Mental health resources and initiatives such as No-Meeting Fridays.
- Flexible time-off policy.
- Employee Stock Purchase Plan (ESPP) offering discounted equity opportunities.
- Reimbursement for office setup expenses.
- Monthly cell phone & internet stipend.
- Remote-first culture.
- Paid parental leave for all new parents.
