Clover Health is seeking an experienced and detail-oriented Senior Manager, Dental Operations to oversee the end-to-end operational performance of Clover’s dental benefit. This role will have responsibility for ensuring seamless execution across all operational domains and delivering a high-quality experience for members and providers.
This leader will be responsible for monitoring, managing, and improving dental operations across configuration, claims, call center, billing, ID cards, provider payments, A&G, and prior authorizations, working closely with both internal teams and external vendor partners. The role requires strong cross-functional collaboration, operational rigor, and the ability to manage performance against defined service levels and business objectives.
The ideal candidate brings deep experience in dental or healthcare operations, strong vendor and stakeholder management skills, and a track record of driving operational excellence in complex environments.
As a Senior Manager, Dental Operations, you will:
- Own end-to-end operational oversight of Clover’s dental benefit, ensuring accurate and timely execution across all core functions.
- Monitor and manage performance across key operational areas, including:
- Eligibility and benefits configuration
- Claims processing and adjudication
- Call center operations and member/provider support
- Billing and premium reconciliation
- ID card production and distribution
- Provider payments and remittance processes
- Appeals & Grievances (A&G)
- Prior authorizations
- Establish, track, and report on service level agreements (SLAs) and key performance indicators across internal teams and external vendors.
- Serve as the primary point of accountability for operational performance, identifying issues, driving root cause analysis, and ensuring timely resolution.
- Partner with external vendors and internal stakeholders to ensure contractual obligations and performance standards are met.
- Lead regular business reviews with vendors and cross-functional partners to assess performance and drive continuous improvement.
- Identify opportunities to improve operational efficiency, accuracy, and member and provider experience.
- Support implementation activities for benefits and operational changes, ensuring readiness across all operational functions.
- Develop and maintain documentation, workflows, and governance structures to support scalable operations.
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