Specialist Navigator

Field - New Jersey. Posted 3 months ago

The role

The Specialist Navigator acts as a liaison between Network Performance and specialist providers. You will translate data-driven insights into provider action to improve quality, access, affordability, and network outcomes.

What you will do

Serve as the primary liaison between Network Performance and specialist providers
Partner with Network Performance to develop contracts for specialist and ancillary providers
Develop and maintain trusted relationships with specialist providers
Lead data-driven discussions with providers regarding utilization trends and referral patterns
Partner with specialists to identify barriers to outpatient utilization
Educate and support providers by discussing scheduling behaviors
Monitor provider adoption of recommended practice changes
Leverage reporting and insights to identify utilization opportunities and prioritize outreach
Track, analyze, and report key performance indicators
Collaborate with Analytics, Clinical, and Network Performance teams

Required qualifications

Reside in New Jersey or within the tristate area
Ability to travel up to 50%
Experience working with providers, health plans, value-based care organizations, or healthcare consulting teams to improve performance outcomes
Prior experience with provider contracting, rate negotiation, or network development

Benefits

Competitive base salary
Equity opportunities
Performance-based bonus program
401k matching
Regular compensation reviews
Medical, dental, and vision coverage
No-Meeting Fridays
Monthly company holidays
Mental health resources
Flexible time-off policy
Learning programs, mentorship, and professional development funding
Employee Stock Purchase Plan (ESPP)

Before you apply

Must reside in New Jersey or within the tristate area
Must have the ability to travel up to 50%
E-Verify company

About the company

Clover Health is reinventing health insurance by combining data with human empathy. They use custom software and analytics to empower clinical staff to provide personalized care.