Data Analyst, Value-Based Care Analytics

This is a fully remote position, open to applicants in United States.

📋 Description

• Establish and sustain essential Value-Based Care (VBC) performance metrics spanning risk, quality, utilization, and cost areas, including HCC capture rates, RAF scores, PMPM trends, and inpatient/ED utilization rates.

• Create customer-oriented analytics, reports, and dashboards that present actionable performance insights for payer and provider partners in a compelling, narrative-driven format.

• Examine Medicare Advantage performance data, focusing on risk adjustment, quality bonus payments, and benchmark performance, to uncover gaps, trends, and opportunities at the patient, provider, and market levels.

• Convert intricate data findings into executive-ready narratives: written summaries, presentation-ready visuals, and structured QBR materials that effectively communicate the story of performance and future actions.

• Perform in-depth utilization and cost analyses, including reviews of high-cost claimants, patterns of avoidable utilization, and trends in specialty/pharmacy spending, to pinpoint areas for enhancement.

• Collaborate with Customer Success and Provider Operations teams to prepare and deliver performance reviews (QBRs, monthly reporting packages) that demonstrate value and highlight priority action areas for each client.

• Work alongside Data Engineering to verify claims and clinical data pipelines, identify anomalies, and guarantee metric consistency across customer demographics.

• Aid in the creation of scalable analytics infrastructure: reusable SQL libraries, metric definitions, and documentation that empower the team to operate more efficiently.

⛳️ Requirements

• Over 4 years of practical experience in healthcare data analytics, with direct engagement with payer or provider clients in a value-based care environment.

• In-depth knowledge of VBC metrics: risk adjustment (HCC coding, RAF scores), utilization (IP admissions, ED visits, readmissions), and cost (PMPM, total cost of care, benchmark vs. actual).

• Proficient SQL skills, capable of crafting complex queries across claims, eligibility, and clinical datasets in cloud-based warehouses (BigQuery, Snowflake, or similar).

• Outstanding data storytelling skills: adept at translating analytical results into clear narratives and visuals that appeal to both clinical and non-technical audiences.

• Experience in developing customer-facing reports and dashboards; comfortable presenting insights to external stakeholders (health plans, provider groups, ACOs).

🏝️ Benefits

• Financial Well-Being: Our dedication to attracting and retaining top talent starts with a competitive base salary and equity opportunities. Furthermore, we provide a performance-based bonus program, 401k matching, and regular compensation reviews to acknowledge and reward outstanding contributions.

• Physical Well-Being: We emphasize the health and well-being of our employees and their families by offering comprehensive medical, dental, and vision coverage. Your health is important to us, and we invest in ensuring you have access to quality healthcare.

• Mental Well-Being: We recognize the significance of mental health in promoting productivity and maintaining work-life balance. To support this, we provide initiatives such as No-Meeting Fridays, monthly company holidays, access to mental health resources, and a generous flexible time-off policy. Additionally, we adopt a remote-first culture that fosters collaboration and flexibility, enabling our team members to excel from any location.

• Professional Development: Developing internal talent is a key focus for Clover. We offer learning programs, mentorship, professional development funding, and ongoing performance feedback and evaluations.

• 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!