Clover Health

Clover is a healthcare technology company helping members live their healthiest lives with our Medicare Advantage plans.

Provider Incentives Program Manager

Program ManagerProgram ManagerFull TimeRemoteTeam 501-1,000H1B SponsorCompany SiteLinkedIn

Location

United States

Posted

44 days ago

Salary

$75K - $85K / year

Bachelor Degree5 yrs expEnglishSQL

Job Description

• Monthly payment operations (end-to-end): Own the monthly cycle to pay practices for CA submitted visits (prepare payment pack → validate → secure approvals → release payments → reconcile). • Onboarding & maintenance: Design system and work with Provider Success Team to drive practice onboarding into AP systems: collect/validate W-9s, ACH details (ACH only for CPH-administered option), ensure IRS W-9 validation, maintain vendor master data and remittance contacts. • Payment execution across options: Execute accurate and timely payments via various payment systems depending on the practice/payment path. • Explanation of Payment/Remittance Preparation: Produce/coordinate practice-facing Explanation of Payment (EOP) detail for each payment. Ensure EOPs are delivered with/after payment as agreed. • Validations & controls: Run automated and manual validations (member eligibility, submitted status, duplicate detection). Flag and resolve exceptions prior to payment. • Approvals & audit trail: Prepare approval package for Finance; ensure email approvals and audit evidence. Maintain complete documentation for audit (payments, EOPs, approvals, visit extracts). • Reconciliation & true-up: Reconcile payment files vs bank clears and the visit payables report; support quarterly true-ups with partners and prepare the internal control reports. • Cross-functional partnership: Work closely with Data/Analytics to maintain the payables report and with Provider Success to resolve practice disputes, onboarding blockers, and payment holds. • Process Improvement & Scaling: Identify opportunities to streamline and automate incentive payment processes as programs grow. Support new incentive program launches by advising on operational feasibility and payment design. Monitor program performance and recommend improvements to increase efficiency and impact.

Job Requirements

  • You have a Bachelor’s degree in Healthcare Administration, Finance, Business, a related field, or equivalent experience.
  • You have 5+ years of experience in healthcare payment operations, provider incentives, value-based care, or related roles.
  • You have a strong understanding of quality incentive programs, value-based payment models, or provider contracting.
  • You have experience managing complex payment calculations and financial workflows.
  • You have high attention to detail with strong analytical and problem-solving skills.
  • You have clear, proactive communication that can coordinate across Finance, Data, Provider Engagement and external partners.
  • You are able to manage escalations and explain technical/payment issues to non-technical audiences.
  • Preferred Experience: Hands-on experience with AP automation platforms (Tipalti, Bill.com, or similar) and bank ACH processes. Experience with Optum Pay, Intacct, or other provider payment platforms.
  • 3–5+ years in Accounts Payable / payments operations, ideally with ownership of end-to-end pay cycles. Experience in high-volume/complex payables or programmatic provider payments is strongly preferred.
  • Demonstrated ability to design and operate financial controls, audit trails, and 1099/W-9 compliance. Hands-on experience with vendor verification and IRS W-9 validation preferred.
  • Strong Excel skills (VLOOKUP/PIVOT), familiarity with basic SQL or ability to work with data teams to query payables datasets. Comfortable validating data extracts and troubleshooting file rejections.
  • Demonstrated ability to design and operate financial controls, audit trails, and 1099/W-9 compliance. Hands-on experience with vendor verification and IRS W-9 validation preferred.

Benefits

  • Financial Well-Being: Our commitment to attracting and retaining top talent begins with a competitive base salary and equity opportunities. Additionally, we offer a performance-based bonus program, 401k matching, and regular compensation reviews to recognize and reward exceptional contributions.
  • Physical Well-Being: We prioritize the health and well-being of our employees and their families by providing comprehensive medical, dental, and vision coverage. Your health matters to us, and we invest in ensuring you have access to quality healthcare.
  • Mental Well-Being: We understand the importance of mental health in fostering productivity and maintaining work-life balance. To support this, we offer initiatives such as No-Meeting Fridays, monthly company holidays, access to mental health resources, and a generous flexible time-off policy. Additionally, we embrace a remote-first culture that supports collaboration and flexibility, allowing our team members to thrive from any location.
  • Professional Development: Developing internal talent is a priority for Clover. We offer learning programs, mentorship, professional development funding, and regular performance feedback and reviews.
  • Additional Perks: Employee Stock Purchase Plan (ESPP) offering discounted equity opportunities
  • Reimbursement for office setup expenses
  • Monthly cell phone & internet stipend
  • Remote-first culture, enabling collaboration with global teams
  • Paid parental leave for all new parents.
  • And much more!

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