Lead, Special Needs Plan Coordinator

Description

Are you ready to make a lasting impact and transform the healthcare space? We are one of Southern California’s fastest-growing Medicare Advantage plans with an incredible 112% year-over-year membership growth.

Who Are We?

Clever Care was created to meet the unique needs of the diverse communities we serve. Our innovative benefit plans combine Western medicine with holistic Eastern practices, offering benefits that align with our members’ culture and values.

Why Join Us?

We’re on a mission! Our rapid growth reflects our commitment to making healthcare accessible for underserved communities. At Clever Care, you’ll have the opportunity to make a real difference, shape the future of healthcare, and be part of a fast-moving, game-changing organization that celebrates diversity and innovation.

Job Summary

The Lead SNP Coordinator supports the Care Management department with a dual focus on oversight and operational execution. In addition to performing core coordinator responsibilities, this role serves as the point person for daily team support, workload distribution, and quality assurance of Care Management activities.

This position plays a key role in monitoring performance metrics, supporting regulatory readiness, and ensuring the team adheres to timelines and workflows. The Lead Coordinator collaborates closely with the Care Management leadership team, case managers, and external partners to ensure efficient operations, accurate reporting, and timely member interventions, particularly within the Special Needs Plan (SNP) population.

Functions & Job Responsibilities

Team Oversight & Coordination

• Distribute daily tasks and caseload assignments among the coordinator team to ensure balanced workload and timely completion of deliverables.
• Serve as first point of contact for workflow/process questions from team members and escalate issues as appropriate.
• Provide peer support and guidance to Care Management Coordinators to promote accuracy, efficiency, and consistency.
• Assist with onboarding and training of new coordinators and temporary staff.
  
  

Program & Operational Support

• Coordinate and support SNP-related initiatives such as HRA outreach, care plan activities, and care transitions.
• Track completion rates for key activities (e.g., HRA/ICP, TOC follow-ups), and proactively identify areas at risk for non-compliance.
  
  

Facilitate communication between care managers, providers, and internal departments to support seamless member care.

Data, Reporting & Compliance

• Compile and validate data reports to support internal dashboards, audits, and regulatory submissions.
• Monitor team productivity, accuracy of documentation, and adherence to regulatory standards.
• Support preparation for CMS reporting, audits, and SNP MOC deliverables, ensuring timelines are met and documentation is complete.
  
  

Process Improvement

• Identify and recommend process enhancements to streamline operations and improve efficiencies.
• Maintain and update workflows and standard operating procedures in collaboration with management.
• Participate in quality improvement initiatives and project implementation efforts.
• Additional duties, as assigned
  
  

Qualifications

Education and Experience

• Associate degree required; Bachelor's degree preferred. Equivalent combination of education and relevant experience will be considered.
• Strong preference for certification in data analytics.
• 3–5 years of experience in a Care Management or Managed Care environment, with strong preference for prior involvement in Special Needs Plan (SNP).
• Previous experience in a lead, supervisory, or training role within managed care is highly desirable.
  
  

Skills

• Strong leadership and team coordination abilities.
• Excellent organizational and time management skills; able to manage multiple competing priorities.
• Advanced proficiency in Microsoft Office Suite (especially Excel, PowerPoint, and Word).
• Comfort with data tracking and analysis; ability to generate and interpret reports.
• Familiarity with CMS SNP Model of Care (MOC), HRA/ICP processes, and regulatory timelines.
• Excellent communication skills — both verbal and written.
• Demonstrated ability to work independently and exercise sound judgment.
• Ability to maintain confidentiality and manage sensitive information with discretion.
• Bilingual proficiency in Spanish, Mandarin, Cantonese, Vietnamese, Khmer, or Korean is a plus
  
  

Wage Range: $28.00 to $32.00 per hour

Physical & Working Environment.

Physical requirements needed to perform the essential functions of the job, with or without reasonable accommodation:

• Must be able to travel when needed or required
• Must be able to travel in Orange County and Los Angeles County area
• Ability to operate a keyboard, mouse, phone and perform repetitive motion (keyboard); writing (note-taking)
• Ability to sit for long periods; stand, sit, reach, bend, lift up to fifteen (15) lbs.
  
  

Ability to express or exchange ideas to impart information to the public and to convey detailed instructions to staff accurately and quickly

Work is performed in an office environment and/or remotely. The job involves frequent contact with staff and public. May occasionally be required to work irregular hours based on the needs of the business

Clever Care Health Plan is proud to be an Equal Employment Opportunity and Affirmative Action workplace. Individuals seeking employment will receive consideration for employment without regard to race, color, national origin, religion, age, sex (including pregnancy, childbirth or related medical conditions), sexual orientation, gender perception or identity, age, marital status, disability, protected veteran status or any other status protected by law. A background check is required.

Salary ranges posted on the job posting are based on California wages. Salary may be higher or lower depending on the candidate’s state residency.