Director, Clinical Business Operations

Director, Clinical Business Operations

The Clover Care Services organization delivers proactive support and care to our members through our clinical Clover Home Care teams, and quality improvement services to our aligned providers through our practice engagement team. Clover has built one of the most proactive, data-driven health care services platforms and is excited about how technology impacts our ability to bring transformative results to both patients and providers.

The Director, Clinical Business Operations is a strategic and analytical leader responsible for the financial and operational infrastructure that supports Clover Care Services clinical programs. This role oversees business operations across CCS ensuring that Clover's care delivery model operates efficiently, effectively, and in alignment with budget and growth goals.

The Director, Clinical Business Operations will partner closely with Clinical Operations, Clinical leadership, and Finance to develop and manage budgets, forecast volume and staffing needs, oversee vendor and cost-center performance, and implement scalable operational processes that drive both clinical and financial outcomes. This role combines operational acumen, financial discipline, and a process-improvement mindset someone who thrives at the intersection of data, execution, and strategy.

As Director of Clinical Business Operations, you will :

• Lead financial and operational planning for Clover Care Services, including cost center oversight, budgeting, forecasting, and alignment of spend with visit volumes and growth goals.
• In partnership with the Chief Operating Officer, manage vendor relationships and contracting, ensuring efficiency, compliance, and alignment with operational and financial objectives.
• Oversee call center and scheduling operations performance for CCV operations (staffing levels, capacity, reach rates, scheduling utilization, productivity metrics) to optimize patient access and team efficiency.
• Drive productivity and logistics management for clinical and administrative support functions, including visit volume tracking, staffing models, and capacity planning.
• Support revenue cycle management by ensuring accurate and timely billing, claims processing, denial management, and issue resolution in partnership with Finance and Compliance.
• Lead EHR systems oversight, including provider education, configuration management, and issue escalation to ensure seamless operational workflows.
• Develop and implement standardized workflows and procedures that promote consistency, scalability, and operational excellence across care delivery support teams.
• Partner in modeling and forecasting, developing data-driven projections for visits, enrollment, and staffing to guide strategic decision-making.
• Collaborate cross-functionally with clinical and business leaders to align operational performance with quality, cost, and patient / member experience goals.
• Monitor operational performance metrics and lead continuous improvement initiatives to increase efficiency and reduce cost per visit.
• Ensure financial stewardship, including invoice review, spend tracking, and cost management for all CCS vendors and contractors.
• Support OKR development and management, ensuring key performance indicators are aligned with organizational strategy and regularly reported.

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About Clover :

We are reinventing health insurance by combining the power of data with human empathy to keep our members healthier. We believe the healthcare system is broken, so we've created custom software and analytics to empower our clinical staff to intervene and provide personalized care to the people who need it most.

We always put our members first, and our success as a team is measured by the quality of life of the people we serve. Those who work at Clover are passionate and mission-driven individuals with diverse areas of expertise, working together to solve the most complicated problem in the world : healthcare.

From Clover's inception, Diversity & Inclusion have always been key to our success. We are an Equal Opportunity Employer and our employees are people with different strengths, experiences and backgrounds, who share a passion for improving people's lives. Diversity not only includes race and gender identity, but also age, disability status, veteran status, sexual orientation, religion and many other parts of one's identity. All of our employee's points of view are key to our success, and inclusion is everyone's responsibility.

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