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.
Success in this role looks like:
In your first 90 days, you will:
- Develop a deep understanding of Clover’s dental operational model and vendor landscape.
- Establish visibility into current performance across all operational domains.
- Identify key gaps, risks, and opportunities for improvement.
- Build strong relationships with internal stakeholders and external partners.
After 6 months, you will:
- Drive measurable improvements in operational performance, SLA adherence, and issue resolution timelines.
- Establish a consistent cadence of reporting, governance, and business reviews.
- Improve coordination and accountability across internal and external teams.
Future success in this role includes:
- High-performing, reliable dental operations that deliver a seamless member and provider experience.
- Strong vendor partnerships with clear accountability and continuous improvement.
- Scalable operational processes that support Clover’s growth in Medicare Advantage.
You should get in touch if:
- Bring 6–10+ years of experience in dental or healthcare operations, ideally within a dental benefit administrator, health plan, or vendor environment.
- Have experience managing or overseeing end-to-end operational functions such as claims, call center, billing, or prior authorizations.
- Have strong experience with vendor management and SLA oversight, including holding partners accountable to performance standards.
- Possess a solid understanding of dental benefits, claims processing, and operational workflows.
- Demonstrate strong analytical and problem-solving skills, with the ability to identify root causes and drive resolution.
- Are highly organized and able to manage multiple complex workstreams simultaneously.
- Thrive in cross-functional environments and can influence stakeholders without direct authority.
- Are comfortable operating in a fast-paced, evolving environment and building structure where needed.
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.