Remote-First Strategic Network Navigator

Clover Health; South Carolina; Hybrid; USD 115,000 - 150,000; Full time

Job summary

The Specialist Navigator at Clover Health sits at the intersection of provider relationships, utilization management, and network performance. This role is the primary liaison between Clover's Network Performance team and specialist providers, translating data-driven insights into actionable improvements.

This position involves travel up to 50%, primarily within New Jersey and Pennsylvania, with opportunities to engage across South Carolina and Georgia as needed.

Qualifications

• Serve as the primary liaison between Network Performance and specialist providers.
• Develop contracts for specialist and ancillary providers.
• Build trusted relationships with specialist providers to improve quality, access and cost.
• Lead data-driven discussions on utilization, referrals, and practice variation.

Responsibilities

• Drive the Specialist Optimization Initiative using analytics.
• Partner with Network Performance to craft contracts for a high-performing specialist network.
• Educate and support providers on scheduling behaviors to meet optimization goals.
• Monitor adoption of practice changes and assess impact on referrals.

Job description

The Specialist Navigator at Clover Health sits at the intersection of provider relationships, utilization management, and network performance. This role is the primary liaison between Clover's Network Performance team and specialist providers, translating data-driven insights into actionable improvements.

This position involves travel up to 50%, primarily within New Jersey and Pennsylvania, with opportunities to engage across South Carolina and Georgia as needed.