Find your next role
Discover roles across ambitious teams
12,642 jobs
- More jobs
Clover Health
Business Analyst, Clinical & Reimbursement Policy
Remote · USA · Full time · Mid level
$107k–$130k / year
About the role
Serve as the strategic bridge between regulatory requirements and automated execution for clinical and reimbursement policies. Ensure policies are accurately interpreted, updated, and integrated into claims environment.
What you’ll do
• Own development and maintenance of clinical and reimbursement policies. • Interpret and operationalize Medicare guidelines including NCDs and LCDs. • Manage external vendor performance and policy monitoring. • Lead AI initiatives to automate reimbursement policy monitoring. • Collaborate with teams to synchronize policy intent with adjudication.
What you’ll bring
• 5+ years in healthcare claims or reimbursement policy. • Expertise in Medicare Advantage and policy interpretation. • Experience managing vendor relationships strategically. • Passionate about AI and emerging technologies. • Preferred coding certifications like CPC, CCS, COC, or CIC.
Life at Clover Health
Offers competitive salary, equity, bonuses, 401k matching, comprehensive health coverage, mental health resources, remote-first culture, professional development, and parental leave.
About Clover Health
Clover Health combines data and empathy to improve member health through personalized care and innovative health insurance solutions.