Job Description

The Clover Care Services organization delivers proactive support and care to our members through our Clover Home Care teams, and quality improvement services to our aligned insurance plan providers through our practice engagement team. We have built one of the most proactive, data-driven health care services platforms in New Jersey and are excited about the future of technology and how it impacts our ability to bring transformative results to both patients and providers.

As a Senior Clinical Data Analyst in the Clover Care Services (CCS) organization, you will help drive better patient outcomes, improve care coordination, and optimize resource utilization by providing actionable insights to health care providers, practice administrators and CCS leadership. In this role you will be called upon to develop dashboards that measure external provider performance, generate population health management insights as well as respond to data requests that provide an operational perspective relative to business unit OKRs.

The right person must be a data-driven, highly analytical problem-solver with exceptional organizational skills, and passionate about our mission.

As a Senior Clinical Data Analyst, you will:

• Gather requirements from stakeholders and translate to specific and actionable work tasks.
• Develop complex SQL queries to support data-driven insights that inform business and clinical decisions.
• Analyze healthcare data (claims, lab, pharmacy and EMR data) to draw conclusions and provide consultation to stakeholders for use in administering specific programs and operational processes.
• Develop reports, dashboards, and visualizations that provide insights into various patient populations and health care utilization patterns.
• Partner closely with clinical and operational teams to ensure data-driven decision-making and assist in the assessment of treatment concordant care.
• Analyze CCS operations relative to goals and summarize the completion of routine tasks by various business unit resources.
• Ensure data accuracy, quality, and integrity when working across multiple data sets.
• Prepare and present findings and recommendations to leadership, internal clinical teams, and external stakeholders in support of Clover Care Services business initiatives.

Success in this role looks like:

• In your first 90 days, you will:
  • Learn the intricacies of the various data sets available to measure Clover Care Services business initiatives.
  • Successfully build and deliver on a few high-priority data reporting requests.
  • Create a ticketing infrastructure for the intake data report request.
• After 6 months you will:
  • Partner with stakeholders to analyze, design, and implement approaches to measure external and internal provider performance.
  • Provide consistent, high-quality reporting to the CCS business unit.
• Future success in this role includes:
  • Strategic Impact: Play a pivotal role in generating insights that demonstrate the value delivered by the CCS business unit.
  • Organizational Development: Foster a culture of continuous improvement, innovation, and excellence within the organization.

You should get in touch if:

• You have a BA/BS in Mathematics, Statistics, Economics, Healthcare, or a related discipline, with 5+ years of relevant professional experience.
• You have strong SQL proficiency with experience querying, summarizing, and manipulating large healthcare datasets.
• You have hands-on experience analyzing medical and pharmacy claims data, including medical cost modeling, utilization analysis, trend analysis, and PMPM calculations.
• You have experience with healthcare actuarial concepts, including risk adjustment methodologies (e.g., HCC, RAF), population risk stratification, and enrollment/eligibility analysis.
• You have knowledge of healthcare data standards and coding systems (ICD-10, CPT, DRG) and familiarity with healthcare quality measures (e.g., HEDIS, CMS, NCQA), preferably within Medicare Advantage.
• You have the ability to validate data quality, identify anomalies, document analytical assumptions, and perform member-level longitudinal analyses.
• You have strong communication skills with the ability to translate complex analytical findings into clear, actionable insights and present them to actuarial, clinical, financial, and operational stakeholders using tools such as Excel and data visualization platforms (e.g., Tableau, Power BI).

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!

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.

#LI-REMOTE

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.

Final pay is based on several factors including but not limited to internal equity, market data, and the applicant’s education, work experience, certifications, etc.

A reasonable estimate of the base salary range for this role is: $115,000—$133,000 USD