Specialist Network Navigator - Remote/Travel

Clover Health; United States; Remote; USD 115,000 - 150,000; Full time

Benefits offered by this job

Employee Stock Purchase Plan (ESPP)

Office setup reimbursement

Monthly cell phone stipend

Remote-first culture

Paid parental leave

Job summary

Clover Health is seeking a Specialist Navigator to bridge Network Performance and specialist providers, translating data-driven insights into action that improves quality, access, affordability, and network outcomes. Role involves travel within New Jersey, Pennsylvania, and occasional trips to South Carolina and Georgia.

You will lead consultations on utilization, practice variation, and network optimization strategies, developing partnerships with providers and supporting rate negotiations and

Qualifications

• Experience with provider contracting and network development.
• Data-driven approach to improving utilization and outcomes.
• Ability to travel up to 50% across the U.S.

Responsibilities

• Serve as the primary liaison between Network Performance and specialist providers, driving optimization initiatives and measurable performance improvements.
• Partner with Network Performance to develop contracts for specialist and ancillary providers.
• Develop and maintain trusted relationships with specialist providers to improve quality, access, affordability, and network performance.
• Lead data-driven discussions with providers regarding utilization trends and referral patterns.
• Identify barriers to outpatient utilization and implement strategies to improve efficiencies when clinically appropriate.
• Educate providers on scheduling behaviors to support network optimization and quality outcomes.

Skills

Provider relationships

Utilization management

Network performance

Data analytics

Contract negotiation

Relationship management

Job description

Clover Health is seeking a Specialist Navigator to bridge Network Performance and specialist providers, translating data-driven insights into action that improves quality, access, affordability, and network outcomes. Role involves travel within New Jersey, Pennsylvania, and occasional trips to South Carolina and Georgia.

You will lead consultations on utilization, practice variation, and network optimization strategies, developing partnerships with providers and supporting rate negotiations and