[Hiring] Senior Manager, Dental Operations @Clover Health

Role Description

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
• Appeals & Grievances (A&G)
• Prior authorizations

The role requires strong cross-functional collaboration, operational rigor, and the ability to manage performance against defined service levels and business objectives.

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.

Qualifications

• 6–10+ years of experience in dental or healthcare operations, ideally within a dental benefit administrator, health plan, or vendor environment.
• Experience managing or overseeing end-to-end operational functions such as claims, call center, billing, or prior authorizations.
• Strong experience with vendor management and SLA oversight, including holding partners accountable to performance standards.
• Solid understanding of dental benefits, claims processing, and operational workflows.
• Strong analytical and problem-solving skills, with the ability to identify root causes and drive resolution.
• Highly organized and able to manage multiple complex workstreams simultaneously.
• Thrive in cross-functional environments and can influence stakeholders without direct authority.
• Comfortable operating in a fast-paced, evolving environment and building structure where needed.

Benefits

• Financial Well-Being: Competitive base salary and equity opportunities, performance-based bonus program, 401k matching, and regular compensation reviews.
• Physical Well-Being: Comprehensive medical, dental, and vision coverage.
• Mental Well-Being: Initiatives such as No-Meeting Fridays, monthly company holidays, access to mental health resources, and a generous flexible time-off policy.
• Professional Development: Learning programs, mentorship, professional development funding, and regular performance feedback and reviews.
• Additional Perks: Employee Stock Purchase Plan (ESPP), reimbursement for office setup expenses, monthly cell phone & internet stipend, remote-first culture, paid parental leave for all new parents.