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Role Overview:
- Lead UM Medical Directors in making timely, evidence-based medical necessity decisions.
- Evaluate outpatient referrals and inpatient admissions for medical appropriateness.
Key Responsibilities:
- Manage a team, review complex cases, and chair the Utilization Management Committee.
- Partner with clinical and operational teams to maintain policies and improve quality.
Benefits:
- Competitive salary, equity, bonus, and 401(k) match.
- Comprehensive medical, dental, vision, flexible time-off, and parental leave.
Clover Health
Clover Health provides healthcare plans for America's seniors, using data and technology through the Clover Assistant to support physicians. The company is mission-driven and diverse, focused on improving members' lives through personalized care.