The Clover Care Services organization delivers proactive support and care to our members through our clinical Clover Home Care teams, and quality improvement services to our aligned providers through our practice engagement team. Clover has built one of the most proactive, data-driven health care services platforms and is excited about how technology impacts our ability to bring transformative results to both patients and providers.
We are hiring for a Pharmacy Stars Lead who will be responsible for the design, performance, and continuous improvement of Clover’s Medicare Pharmacy Stars strategy. In this role you will lead the operational and strategic efforts across Pharmacy measures—including SUPD, Poly ACH, COB, and medication adherence metrics (DM, Statin, RAS, SPC)—to optimize outcomes for members and ensure Clover meets CMS Star Rating goals. This is an ideal role for a highly analytical and innovative leader who thrives on solving complex problems, managing vendor ecosystems, and developing data-driven engagement strategies to improve medication adherence, cost savings, and overall member wellbeing.
As a Senior Manager, Pharmacy Stars Strategy & Performance, you will:
- Own the performance and continuous improvement of Pharmacy Stars measures.
- Manage the total P&L for the Part D domain, overseeing vendor spend, internal operating costs, and incentive models to optimize financial performance and maximize return on investment.
- Lead the strategic direction and execution of the Part D Stars roadmap and annual performance targets.
- Manage all vendor partnerships related to pharmacy to ensure accountability and impact.
- Oversee the Part D performance tracking and data review process to drive insights and operational excellence.
- Contribute to Clover’s digital engagement strategy to support members’ medication adherence and cost management.
- Partner with cross-functional teams to identify and leverage synergies between pharmacy and other clinical or operational initiatives.
- Support Clover’s overall Stars performance and CMS submission processes through collaboration and execution excellence.
- Collaborate closely with CCS and MA plan leaders to align strategy, operations, and outcomes.
- Work with data and analytics teams to drive data-informed decisions and enhance performance insights.
- Stabilize and enhance existing pharmacy operations and vendor performance, establishing new engagement structures where needed.
- Develop and execute a sustainable Pharmacy Stars improvement framework that drives higher member engagement and stronger Stars outcomes year over year.
Success in this role looks like:
- In the first 90 days, you will:
- Develop and communicate enhancements to the MY2026 Part D strategy.
- Participate in onboarding activities that involve meeting the team, getting acquainted with vendor relationships and performance goals.
- Stabilize and enhance existing pharmacy operations and vendor performance, establishing clear engagement structures.
- By 6 months, you will:
- Demonstrate full ownership of the Part D strategies.
- Identify and implement operational improvements across Part D workflows.
- Build strong cross-functional partnerships with CCS and MA plan leaders to align priorities and execution.
- Drive early, measurable progress in key pharmacy performance metrics.
- Beyond 6 months, you will:
- Develop and execute a sustainable Pharmacy Stars improvement framework that drives higher member engagement and stronger Stars outcomes year over year.
- Foster continuous improvement in Pharmacy Stars measures as evaluated by CMS and Clover’s submission vendor.
- Lead ongoing innovation in engagement strategies and vendor performance optimization.
- Achieve measurable improvements in member medication adherence, satisfaction, and overall program performance.
You should get in touch if:
- You have a high level of competence in managing and improving Stars Pharmacy measures.
- You have 5-10 years of proven operational leadership experience.
- You are comfortable and fluent with data-driven decision making.
- You have demonstrated experience in healthcare operations, Stars programs, or pharmacy management (preferred but not required).
- You are passionate about innovation and improving member outcomes.
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 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.
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!
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.