Performance Optimization Leader

Clover Health
Houston
Workplace: OnsiteFull timeFunction: Administration & Executive AssistanceExperience: 7+ yearsSkills: ["Analytical skills","Cross-functional collaboration","Stakeholder influence","Communication","Objectivity"]

Build and lead the end-to-end Quality Assurance program for Clover’s Houston Experience Center. Own quality standards, scorecards, calibration, governance, reporting, appeals, and continuous improvement, ensuring evaluations are fair, consistent, timely, and compliant. Partner with Operations, Training, HR, Compliance, and Member Experience to translate quality insights into coaching, training, process changes, and executive dashboards. Serve as escalation point for complex disputes and act as QA subject matter expert.

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Clover Health
Clover Health
1 day ago

Performance Optimization Leader

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Last checked: 3 hours agoStatus: Live

Job Summary

Build and lead the end-to-end Quality Assurance program for Clover’s Houston Experience Center. Own quality standards, scorecards, calibration, governance, reporting, appeals, and continuous improvement, ensuring evaluations are fair, consistent, timely, and compliant. Partner with Operations, Training, HR, Compliance, and Member Experience to translate quality insights into coaching, training, process changes, and executive dashboards. Serve as escalation point for complex disputes and act as QA subject matter expert.
Location: Houston
Workplace: Onsite
Employment Type: Full time
Job Function: Administration & Executive Assistance
Seniority: Manager level

Key Responsibilities

  • •Own and continuously improve the Quality Assurance program across all member interaction channels.
  • •Establish and evolve quality standards, scorecards, rubrics, and evaluation methodologies aligned to member experience and Medicare Advantage quality measures.
  • •Ensure QA evaluations are fair, consistent, timely, and supported by documented standards and governance.
  • •Build scalable QA processes that support continuous improvement while maintaining regulatory and operational compliance.
  • •Lead governance activities including calibration, inter-rater reliability, audits, appeals, reviewer development, and ongoing program enhancements.

Pay and Benefits

Perks:Equity401kHealth InsuranceDentalVisionLearning BudgetParental Leave

Key Requirements

  • •7+ years of experience in Quality Assurance, Contact Center Operations, Customer Experience, or operational excellence, including experience leading QA programs.
  • •Experience designing, implementing, or scaling Quality Assurance programs in healthcare, insurance, or other regulated customer service environments.
  • •Deep knowledge of quality methodologies, calibration, scorecard development, and performance analytics.
  • •Demonstrated success using quality data to influence operational strategy and improve customer outcomes.
  • •Excellent analytical skills and experience developing dashboards and executive-level reporting.
Experience:7+ yearsHealthcareInsuranceRegulated customer serviceMedicare Advantage
Skills:Analytical skillsCross-functional collaborationStakeholder influenceCommunicationObjectivity
Tech Stack:AI-assisted review toolsSpeech analyticsBusiness intelligence toolsQuality management platformsDashboardsExecutive reporting

Company Brief

Clover Health
Clover Health is a technology-driven health insurance company offering Medicare Advantage plans that combine clinical care coordination, data analytics, and value-based care to improve outcomes and reduce costs for seniors.
Industry: Health Insurance (Payers)
Company Size: Enterprise (1,001+ employees)
Growth: Public Company
Valuation: Public Company (Market Cap in USD)
Funding: IPO / Publicly Listed
Headquarters: Jersey City, United States
Founded: 2014
WebsiteLinkedIn