Supervisor, Medicare Claims

Clever Care Health Plan is one of Southern California's fastest-growing Medicare Advantage plans, renowned for its commitment to serving the diverse healthcare needs of the community through innovative and culturally aligned benefit offerings. Established to bridge the gap between Western medicine and holistic Eastern practices, Clever Care Health Plan designs Medicare plans that consider the unique values and cultural backgrounds of its members, ensuring inclusive and comprehensive healthcare access. This dedication to innovation and community focus has resulted in an impressive 112% year-over-year membership growth, making Clever Care a dynamic and influential player in the healthcare space. Based in Los Angeles and Orange County, Clever Care fosters a collaborative work environment that encourages diversity, innovation, and forward-thinking approaches to healthcare delivery. The organization embraces a hybrid work schedule, affording employees flexibility while maintaining strong teamwork and connection.

As a Claims Supervisor at Clever Care Health Plan, you will play a pivotal role in managing and directing the daily operations of the Claims Department, working under indirect supervision to ensure compliance with Centers for Medicare & Medicaid Services (CMS) regulations alongside Clever Care's internal policies. This leadership position requires you to oversee a dedicated team of claims processing staff, guiding them through complex issues, facilitating professional development, and ensuring accurate, timely claims resolution that supports the organization's strategic objectives. Your role will involve active engagement in process improvement initiatives, staff coaching, and quality assurance efforts to maintain high standards of service and compliance. The supervisor will also participate in strategic planning, performance management, and interdepartmental coordination to drive efficiency and excellence in claims processing.

The Claims Supervisor will bring expertise in Medicare claims management, analytical skills for problem-solving, and the ability to coach and mentor staff with a focus on career development and performance standards. As a leader, you will inspire your team by modeling core values, fostering collaboration, and challenging the status quo to pursue continuous improvement. You will help shape a positive work culture by recognizing contributions and encouraging a shared vision aligned with Clever Care's mission. This role demands a strategic thinker with strong communication and interpersonal skills, capable of navigating complex regulatory environments while maintaining operational effectiveness. The ability to lead by example, empower others, and celebrate successes is critical for this role.

Overall, this position offers a remarkable opportunity to contribute to a fast-growing healthcare organization dedicated to making a lasting impact on underserved communities. The wage range for this role is competitive, from $80,000 to $90,000 annually, reflecting the valuable leadership and expertise required. Candidates must reside in Los Angeles or Orange County to accommodate the hybrid work schedule and participate in essential in-office operations. Clever Care Health Plan is an Equal Employment Opportunity and Affirmative Action employer, committed to diversity and inclusion. Individuals with varied backgrounds and experiences are encouraged to apply, ensuring that the team reflects the vibrant, multicultural community it serves.