Specialist Network Navigator: Data-Driven Provider Liaison

Clover Health; New York (NY); On-site; USD 115,000 - 150,000; Full time

Benefits offered by this job

Employee stock purchase plan (ESPP)

Reimbursement for office setup

Monthly cell phone & internet stipend

Remote-first culture

Paid parental leave

Job summary

Clover Health in the United States seeks a Specialist Navigator to bridge Network Performance and specialist providers, translating analytics into actionable improvements across quality, access, and cost.

This role requires up to 50% travel, primarily within the Northeast and mid-Atlantic, with some travel to other states. You will build contracts, nurture relationships, and lead data‑driven discussions to optimize the specialist network.

Qualifications

• Experience working with providers, health plans, value-based care organizations, or healthcare consulting teams to improve performance outcomes.
• Experience with provider contracting, rate negotiation, or network development.
• Ability to use data to uncover opportunities and drive measurable operational change.

Responsibilities

• Serve as the primary liaison between Network Performance and specialist providers, driving the Specialist Optimization Initiative and translating analytics into provider action.
• Partner with Network Performance to develop contracts for specialist and ancillary providers to build an efficient, high-performing network.
• Develop and maintain trusted relationships with specialist providers to improve quality, access, affordability, and network performance.
• Lead data-driven discussions with providers on utilization trends, referral patterns, and site-of-service opportunities.
• Identify barriers to outpatient utilization and implement strategies to improve effectiveness and efficiency when clinically appropriate.
• Educate and support providers on scheduling behaviors to support network optimization while maintaining quality outcomes.
• Monitor provider adoption of recommended practice changes and assess shifts in referral behavior.
• Leverage analytics to identify utilization opportunities, prioritize outreach, and measure intervention effectiveness.
• Report key performance indicators and provide feedback to leadership on trends and opportunities.
• Collaborate with Analytics, Clinical, and Network Performance teams to support network optimization initiatives.

Job description

Clover Health in the United States seeks a Specialist Navigator to bridge Network Performance and specialist providers, translating analytics into actionable improvements across quality, access, and cost.

This role requires up to 50% travel, primarily within the Northeast and mid-Atlantic, with some travel to other states. You will build contracts, nurture relationships, and lead data‑driven discussions to optimize the specialist network.