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Sr. Manager, Medicare Strategy

Role overview

Qualifications

  • Bachelor’s degree in Finance, Economics, Business, Healthcare Administration, or a related field; MBA or other advanced degree highly preferred
  • 7-10+ years of experience in strategic planning, corporate development, finance, or management consulting, preferably in Medicare Advantage or managed care
  • Exceptional quantitative analysis skills; ability to build and manage high level multi-year financial and membership scenario models
  • Deep understanding of Medicare Advantage economics, bid mechanics, and the drivers of profitable growth

Responsibilities

  • Lead the annual bid development process, ensuring alignment between strategic goals, financial targets, and benefit design
  • Build and lead Clover’s competitive intelligence capability, integrating competitor enrollment, benefit design, pricing, market strategy, and broader industry trends
  • Evaluate the performance and strategic fit of the product portfolio and present data-driven recommendations for product enhancements
  • Drive evaluation of new geographic markets and develop the playbook for market entry

Key facts

  • Remote from: United States
  • Full time
  • Senior (5-10 years)
  • 168 - 168K yearly
  • English

Other skills

  • Strategic Planning
  • Communication
  • Problem Solving
  • Teamwork

About the company

Clover Health logo

Clover Health

Health Insurance (Payers)

Clover Health (Nasdaq: CLOV) is a physician enablement company focused on seniors who have historically lacked access to affordable, high-quality healthcare We aim to provide great care, in a sustainable way, by having a business model built around improving medical outcomes while lowering avoidable costs. We do this while taking a holistic approach to understanding the health needs and social risk factors of those under our care. This strategy is underpinned by our proprietary software platform, the Clover Assistant, which is designed to aggregate patient data from across the health ecosystem to support clinical decision-making by presenting physicians and other providers with real-time, personalized recommendations at the point of care. Making care more accessible is at the heart of our business, and we believe patients should have the freedom to choose their doctors. We offer affordable Medicare Advantage plans with extensive benefits, provide primary care physicians with the Clover Assistant, and also make comprehensive home-based care available via the Clover Home Care program. With our corporate headquarters in Nashville, Clover’s workforce is distributed around the U.S. and also includes a team of world-class technologists based in Hong Kong. We manage care for Medicare Advantage members in Alabama, Arizona, Georgia, Mississippi, New Jersey, Pennsylvania, South Carolina, Tennessee, and Texas. We are hiring software engineers, data scientists, designers and product folks who can help us understand our members’ wellness and steer them clear of any health risks down the road. If you’re a passionate person and interested in changing healthcare for the better, then Clover Health may just be the place for you.

Company details

Company typeScaleup
IndustryHealth Insurance (Payers)
Company size501 - 1000

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Job description

At Clover Health, we are committed to providing high-quality, affordable, and easy-to-understand healthcare plans for America’s seniors. We prioritize preventive care while leveraging data and technology through the Clover Assistant, a powerful tool that helps physicians make informed health recommendations. By giving doctors a holistic view of each member’s complete health history, we ensure better care at a lower cost—delivering the highest value to those who need it most.

The Finance organization owns product strategy and bid development, long term profitable growth strategy and new market evaluation and execution, and strategic projects. In this role, you will report to the Chief of Staff to the CFO.

Clover Health is seeking a dynamic, strategic, and highly analytical leader to join our team as the Senior Manager, Medicare Strategy. This pivotal role is responsible for long-term profitable growth strategy, bid strategy and pricing, AEP planning, and execution of strategic projects.

Reporting to the Chief of Staff to the CFO, this role will lead the development and execution of Medicare growth, product, and bid strategies, bringing together financial, market, operational, and competitive insights to influence enterprise decisions. The Senior Manager will frame strategic options, recommend tradeoffs, and align cross-functional leaders around plans that support profitable growth.

This is an ideal opportunity for a strategic thinker who excels at complex problem-solving and can translate data into actionable, market-specific plans, and execution.

As a Sr. Manager, Medicare Strategy, you will:

  • Bid Strategy & Program Management: Lead the annual bid development process, ensuring alignment between strategic goals, financial targets, and benefit design. Define the PBP-specific strategy considering positioning, growth potential, MCR targets, and service area. Recommend innovative supplemental benefit offerings.
  • Competitive Intelligence: Build and lead Clover’s competitive intelligence capability, integrating competitor enrollment, benefit design, pricing, market strategy, and broader industry trends into recommendations that shape product, bid, and market decisions. Develop scalable, AI-enabled tools and frameworks that enable ongoing use across the organization.
  • Product Strategy: Evaluate the performance and strategic fit of the product portfolio. Develop and present data-driven recommendations for product enhancements, repositioning, or new plan launches to achieve profitable growth.
  • Benefit Strategy: Shape detailed strategy for benefit changes, partner with Actuarial on financial impact and Growth team on sales impact and competitive positioning.
  • P&L Modeling: Develop and interpret multi-year scenario models to forecast membership growth and financial performance and inform long-term strategic decisions.
  • New Market Evaluation and Execution: Drive evaluation of new geographic markets. Develop and execute the playbook for market entry, defining resource needs, key milestones, and cross-functional ownership from initial analysis to operational launch (network adequacy, bid strategy, growth execution).
  • Performance Reporting: Oversee analysis and preparation for monthly business reviews in partnership with the Chief of Staff.
  • Special Projects: Lead the evaluation and strategy development for innovative partnerships and other priority growth initiatives. Execute and own projects end to end, from recommendation through implementation.

Success in this role looks like:

  • Successfully leading the annual bid process in partnership with the Chief of Staff, delivering a competitive and financially sound product portfolio that supports profitable membership growth.
  • Acting as a SME with Clover’s and competitor’s benefits, and working cross-functionally with Actuarial, Finance, Growth, and Operations to implement benefits.
  • Owning the development and launch of new, scalable AI-enabled tools and reports that provide actionable competitive intelligence to leadership and key business partners.
  • Creating robust enrollment and financial models that directly inform and influence the company's long-term growth strategy, including decisions on product design and new market entry.

You should get in touch if:

  • Bachelor’s degree in Finance, Economics, Business, Healthcare Administration, or a related field; MBA or other advanced degree highly preferred.
  • 7-10+ years of experience in strategic planning, corporate development, finance, or management consulting, with a strong preference for experience within the Medicare Advantage or managed care industry.
  • Exceptional quantitative analysis skills; ability to build and manage high level multi-year financial and membership scenario models.
  • Deep understanding of Medicare Advantage economics, bid mechanics, and the drivers of profitable growth. Deep understanding of Medicare benefits and pricing.
  • Demonstrated experience leading market expansion or new product development projects from concept to execution.
  • Proven ability to analyze competitor strategies and market trends to inform business decisions.
  • Excellent project management skills and experience leading large-scale, cross-functional initiatives.
  • Outstanding communication and presentation skills, with the ability to distill complex information into clear, actionable insights for an executive audience.
  • A proactive, results-oriented mindset with the ability to thrive in a fast-paced, dynamic environment.

Benefits Overview:  

  • Financial Well-Being: Our commitment to attracting and retaining top talent begins with a competitive base salary and equity opportunities. Additionally, we offer a performance-based bonus program, 401k matching, and regular compensation reviews to recognize and reward exceptional contributions.
  • Physical Well-Being: We prioritize the health and well-being of our employees and their families by providing comprehensive medical, dental, and vision coverage. Your health matters to us, and we invest in ensuring you have access to quality healthcare.
  • Mental Well-Being: We understand the importance of mental health in fostering productivity and maintaining work-life balance. To support this, we offer initiatives such as No-Meeting Fridays, monthly company holidays, access to mental health resources, and a generous flexible time-off policy. Additionally, we embrace a remote-first culture that supports collaboration and flexibility, allowing our team members to thrive from any location. 
  • Professional Development: Developing internal talent is a priority for Clover. We offer learning programs, mentorship, professional development funding, and regular performance feedback and reviews.

Additional Perks:

  • Employee Stock Purchase Plan (ESPP) offering discounted equity opportunities
  • Reimbursement for office setup expenses
  • Monthly cell phone & internet stipend
  • Remote-first culture, enabling collaboration with global teams
  • Paid parental leave for all new parents
  • And much more!

About Clover: We are reinventing health insurance by combining the power of data with human empathy to keep our members healthier. We believe the healthcare system is broken, so we've created custom software and analytics to empower our clinical staff to intervene and provide personalized care to the people who need it most.

We always put our members first, and our success as a team is measured by the quality of life of the people we serve. Those who work at Clover are passionate and mission-driven individuals with diverse areas of expertise, working together to solve the most complicated problem in the world: healthcare.

From Clover’s inception, Diversity & Inclusion have always been key to our success. We are an Equal Opportunity Employer and our employees are people with different strengths, experiences, perspectives, opinions, and backgrounds, who share a passion for improving people's lives. Diversity not only includes race and gender identity, but also age, disability status, veteran status, sexual orientation, religion and many other parts of one’s identity. All of our employee’s points of view are key to our success, and inclusion is everyone's responsibility.


#LI-REMOTE

Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records. We are an E-Verify company.

Final pay is based on several factors including but not limited to internal equity, market data, and the applicant’s education, work experience, certifications, etc.

A reasonable estimate of the base salary range for this role is:
$129,200$168,000 USD

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Marcus Rivera

Chief Revenue Officer

m.rivera@company.com
linkedin.com/in/marcusrivera
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