Note: The job is a remote job and is open to candidates in USA. Clover Health is reinventing health insurance by combining data power with human empathy to improve member health. As a Senior Clinical Data Analyst, you will provide actionable insights to healthcare providers and leadership, develop dashboards, and ensure data accuracy to optimize patient care and resource utilization.
Responsibilities
- 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
Skills
- 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
- Competitive base salary and equity opportunities
- Performance-based bonus program
- 401k matching
- Regular compensation reviews to recognize and reward exceptional contributions
- Comprehensive medical, dental, and vision coverage
- No-Meeting Fridays
- Monthly company holidays
- Access to mental health resources
- Generous flexible time-off policy
- Remote-first culture that supports collaboration and flexibility
- Learning programs, mentorship, professional development funding, and regular performance feedback and reviews
- Employee Stock Purchase Plan (ESPP) offering discounted equity opportunities
- Reimbursement for office setup expenses
- Monthly cell phone & internet stipend
- Paid parental leave for all new parents
Company Overview
Clover is a healthcare technology company helping members live their healthiest lives with its Medicare Advantage plans. It was founded in 2014, and is headquartered in Nashville, Tennessee, USA, with a workforce of 501-1000 employees. Its website is http://cloverhealth.com.