Senior Manager, Service Operations

The Membership team is a group of dedicated, hard-working, enthusiastic individuals working at the heart of service operations. This team maintains the business function of our mailroom, enrollment and premium billing activities, including ensuring accuracy and timeliness of enrollment applications, maintaining CMS compliance, resolving escalated issues, and ensuring accurate member data throughout the member's journey with Clover. The team also works on projects to improve the efficiency and accuracy of cross-functional activities of Insurance Operations. The success of insurance operations relies on collaboration with our internal counterparts: Claims, Utilization Management, Appeals, Grievances, and Customer Experience. We are looking to hire a Manager of Service Operations to improve the productivity of Clover's enrollment and mailroom function through strong organizational skills and operational oversight. In this role you will be responsible for overseeing and maximizing the relationship with our Business Process as a service (BPaas) vendor through managing day-to-day interactions, while also ensuring adherence to SLA's and compliance with Clover's internal policies and procedures. As a Manager of Service Operations, you will: Manage all Enrollment and Billing operations effectively, efficiently and compliantly to ensure that applicant and member information is processed accurately, appropriately and timely. Ensure members are billed accurately and timely for monthly premiums and/or Late Enrollment Penalties and that any external subsidies (Low Income or SPAP) are applied accurately and timely so members pay only their liability. Directs and oversees incoming mailroom activities including the scanning, sorting and routing of incoming mail to the appropriate business units. Be the point of contact for regulatory requirements to include Medicare Program Audits, One Third Financial Audits, Quarterly CMS Attestations and implementation of new or revised guidance.