Business Analyst, Clinical & Reimbursement Policy

Clover Health · Remote, USA

Full-timeRemoteToday

Not open to applicants in Nigeria. This employer hires from: United States only. Apply only if you are based there.

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About this role

This Business Analyst role at Clover Health, based remotely in the USA, owns the lifecycle of clinical and reimbursement policies, interpreting Medicare guidelines such as NCDs and LCDs and translating them into logic used in claims processing. The ideal candidate has a strong grasp of Medicare regulations and coding rules, combined with the ability to oversee external vendors and work across policy and technical teams. A standout requirement is serving as the internal subject matter expert on CMS coverage and coding guidance, responsible for keeping policies aligned with federal regulations.

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