Senior Manager, Service Operations

About the role

This Senior Manager, Service Operations position is central to ensuring the smooth operation of our membership services at Clover Health. You will be responsible for the accuracy and efficiency of enrollment, premium billing, and mailroom functions, while also managing our external vendor relationships. In this capacity, you will act as a key steward of operational integrity, safeguarding member data and service continuity. You will own the end-to-end oversight of critical administrative workflows that directly impact member access to care. The role requires a proactive mindset to anticipate risks and implement controls before issues escalate. You will partner closely with cross-functional teams to align operational execution with broader business goals. Your leadership will ensure that our service operations remain compliant, efficient, and resilient. This is a pivotal role for maintaining the trust and satisfaction of our membership base.

Location: Remote (USA)

USA

Engagement: Full-time

Salary: $129,200 - $168,000 USD

Team: Membership

What you'll do

You will oversee daily enrollment, billing, and mailroom operations to guarantee timely and accurate processing of member information. You will manage the relationship with our Business Process as a Service (BPaas) vendor, ensuring adherence to service level agreements and internal policies. You will direct mailroom activities, including scanning, sorting, and distribution of incoming correspondence.

You will serve as a point of contact for regulatory compliance, including Medicare audits and CMS attestations. You will develop and maintain organizational policies and procedures for both internal teams and the BPaas vendor. You will collaborate with internal departments such as Claims, Utilization Management, and Customer Experience to enhance member satisfaction. You will identify and resolve complex operational issues, driving them to a satisfactory conclusion.

You will monitor vendor performance against contractual obligations and regulatory requirements, creating performance scorecards. You will develop and track work plans, setting operational objectives and ensuring resource engagement. You will coordinate with finance teams to reconcile billing discrepancies and ensure revenue integrity. You will implement quality assurance processes to reduce errors and improve the accuracy of member data.

You will lead root cause analysis for operational failures and document corrective action plans. You will support the implementation of new technologies and system enhancements related to service operations. You will provide regular status updates to senior leadership on operational metrics and vendor performance. You will ensure all activities comply with Medicare and CMS regulatory standards. You will streamline processes to improve efficiency and member experience.

Requirements

A minimum of 3 years of experience managing and overseeing vendors or BPaas relationships. At least 5 years of experience in Medicare mailroom, enrollment, or billing operations. Demonstrated ability to build and maintain professional relationships through strong communication skills. Proven capability to manage multiple tasks simultaneously and interpret data from reports and dashboards.

Must be eligible to work in the United States without requiring sponsorship at this time. Must possess a high school diploma or equivalent; a bachelor's degree is preferred. Must have a proven track record of managing complex operational workflows in a regulated environment. Must demonstrate strong judgment and decision-making abilities when handling sensitive member information.

Nice to have: Experience creating presentations and diagrams to illustrate processes and findings.

Skills & tools: Vendor management, BPaas oversight, Enrollment processing, Premium billing, Mailroom operations, Medicare compliance, Regulatory reporting, Cross-functional collaboration, Problem-solving, Performance monitoring, Process improvement.

Practical notes: Clover Health offers a comprehensive benefits package including medical, dental, and vision insurance, 401k matching, and performance-based bonuses. We also provide mental health resources, generous paid time off, and professional development opportunities. Additional perks include an Employee Stock Purchase Plan, office setup reimbursement, and a monthly stipend for cell phone and internet. We are a remote-first company.