Clever Care Health Plan Careers

Join the Clever Care Team

Clever Care was founded to help members of the communities we serve to understand the complexities of their health care. We are dedicated to providing culturally sensitive health care solutions that offer our members better access to the services they need in the language they understand. We deliver on our commitment to our members’ health and well-being by offering plans that connect the benefits of Eastern and Western medicine.

Benefits

Insurance Coverage

Clever Care offers our associates medical, dental and vision plans, as well as Health Care and Dependent Care reimbursement accounts, life insurance, disability, and accident coverage.

Savings

Our competitive 401(k) plan includes a generous company match and vesting schedule.

Paid Time Off

Full time employees are eligible for paid vacation days and sick leave hours. Clever Care observes ten paid holidays per year.

Open Positions

We are looking for people that are as excited as we are to help build a platform that empowers our members and connects Eastern and Western medicine to provide comprehensive health solutions.

hybrid; Arcadia - California

Grievances & Appeals Resolution Specialist

Grievance & Appeals Resolution Specialist will assist with the intake and resolution process for member grievances, appeals and provider disputes, ensuring CMS compliance and NCQA standards and with the State and other mandated guidelines.

Huntington Beach | Arcadia - California

Sales Operations Assistant

Sales Operations Administrative Assistant/Coordinator will assist the Sales Operations team with ongoing daily job responsibilities to manage key action items, special project activities/initiatives, and deadlines.

remote

Vice President of Human Resources

The VP will be an integral part of, and an essential business partner, to the executive team and company as a whole, by building and maintaining a link between the company’s strategic goals and HR programs.

remote

Senior Financial Analyst

Functioning as a key member of the Financial Planning & Analysis team, this role will be focused on providing revenue and healthcare cost analytics and forecasting capabilities for the company’s health plans.

hybrid; Huntington Beach

Care Management Coordinator

The Care Management Coordinator assists the Director of SNP Programs and department staff with coordinating, planning, tracking, managing, and ensuring timely implementation of all projects that flow through the SNP Program department.

remote

Strategy and Operations Analyst

This Analyst / Senior Analyst will have a measurable impact on Clever Care’s success while also having a front-row seat to learn and observe how a growth healthcare services company is built and scaled.

Southern California

Facilities Manager

The Facilities Manager will plan, organize, coordinate, and controls the activities of the facilities department, security services management, and safety programs for Clever Care Health Plans offices and buildings.

Hybrid; Los Angeles | Orange

Salesforce Administrator

We are looking for a proactive individual that can help us continually improve and enhance our Salesforce platform, gathering requirements and feedback and designing best practice solutions.

remote

Accounting Manager

The Accounting Manager will be responsible for the month-end closing, account reconciliation and profit and loss reporting.

remote

Director of Pharmacy

This position is responsible for maintaining and supporting the Medicare formulary and providing clinical and economic data necessary to make formulary decisions.

Huntington Beach | Arcadia - California

Special Needs Plan (SNP) Program Case Manager

The Special Needs Plan (SNP) Program Case Manager provides a holistic care model which involves collaboration with members and their families, caregivers, and providers.

remote

Senior Data Analyst

We are looking for creative analysts with a passion for healthcare to support our mission to improve the lives of our members. Qualified candidates will be interacting closely with data team members and business stakeholders across various business domains.

Hybrid; Los Angeles | Orange

Data Analyst

As a Data Analyst at Clever Care Health Plan, you will be part of a fast-paced, knowledgeable and energetic Data and Analytics team that continuously adapts and expands our data ecosystem.

PDR and Appeals Specialist
Huntington Beach | Arcadia - California

PDR and Appeals Specialist

The Provider Dispute Resolution and Appeals Specialist (“Specialist”) is responsible for processing provider appeals and disputes accurately and timely.

Huntington Beach | Arcadia - California

Provider Operations Associate

Supports the Provider Relations Field Representative to achieve department goals. Responds to customer service and provider relations inquiries from providers and assist with problem resolution of issues. Coordinate’s provider submissions to internal departments via required forms.

remote

VP, Audit & Compliance Officer

The ACO is responsible for overall company’s compliance to federal and state regulations (e.g., CMS, CA DMHC, DOI). The ACO will collaborate and support sales/brokers, providers/vendors, FDR (First-tier, Downstream, Related entities), finance, IT and operations teams to successfully pass regulatory audits.

Case Manager RN
remote

Case Manager RN

works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long term care, for members with high need potential.

Enrollment & Reconciliation Supervisor
Huntington Beach | Arcadia - California

Enrollment & Reconciliation Supervisor

The Medicare Enrollment Supervisor serves as a proxy for the Manager of Enrollment and Reconciliation, overseeing the activities and personnel of the Enrollment department while ensuring its processes operate smoothly.

Claims Examiner III
Huntington Beach | Arcadia - California

Claims Examiner III

Under the direction of the Claims Manager, the Claims Examiner III reviews and adjudicates complex or specialty claims, submitted either via paper or electronically.

Huntington Beach | Arcadia - California

Agency Account Executive (Field Sales)

The Agency Account Executive is responsible for helping the regional teams to achieve Clever Care’s established Medicare enrollment objectives in their assigned language segments, by working with the Regional Managers and Field Agency Leaders to drive enrollments through contracted Agencies and Agents.

Huntington Beach - California

Enrollment Associate

Responsible for creating and maintaining eligibility records and addressing any concerns related to member enrollment.

Member Advocate
Arcadia - California

Member Advocate 1

Member Advocates are the main point of contact at Clever Care; interfacing with members, prospective members, providers, brokers, and vendors.

Telesales
San Diego | Los Angeles | Orange

Medicare Benefits Consultant (Tele-Sales)

The consultant will educate prospective members on Clever Care products and enroll into product of choice over the phone or other sales enrollment channels.