Teams at Clover Health

Lead the evolution of claims payment accuracy by optimizing strategic configurations, managing a small team, and implementing automated solutions to enhance operational efficiency in healthcare plans.

The Senior Strategic Configuration Analyst will validate and test configuration logic for Medicare Advantage claims, ensuring payment accuracy and compliance with CMS regulations. Responsibilities include designing test plans, analyzing defects, managing testing environments, and supporting AI-enabled testing frameworks.

The Senior Claims Researcher audits claims accuracy, conducts root cause analysis, compiles reports, and collaborates with internal teams to ensure correct payment processing.