Senior Analyst, Medicare Stars – Pharmacy Programs

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

📋 Description

• Oversee the complete analytics related to Part D Stars. Act as the sole owner for Stars performance, monitoring KPIs and ROI across pharmacy programs — ensuring that deliverables directly guide interventions and business strategies.

• Develop and sustain data infrastructure. Create, enhance, and validate SQL-based pipelines and datasets that span claims, pharmacy, and vendor sources. Collaborate with Data Engineering on architecture, automation, and documentation in accordance with CMS (Centers for Medicare and Medicaid Services), PQA (Pharmacy Quality Alliance), and internal standards.

• Produce and convey insights. Examine Part D Stars measures to uncover trends, gaps, and early warning indicators. Convert findings into straightforward recommendations and craft dashboards that aid both operational and executive decision-making.

• Assess programs and vendors. Design test-and-learn frameworks to evaluate the impact of Stars campaigns, pharmacy interventions, and vendor initiatives. Establish success metrics, conduct cohort analyses, and apply insights to future enhancements.

• Support cross-functional partners. Serve as the primary analytics liaison for Pharmacy Stars Operations and vendor teams. Connect business requirements to technical teams, and collaborate with Product and Engineering to incorporate insights into Counterpart Assistant and provider workflows.

• Create operational frameworks. Develop standardized analytics processes, SOPs, and intake protocols. Promote consistent use of measure logic and business rules across teams to facilitate a scalable performance management rhythm.

⛳️ Requirements

• 4–6+ years of experience in healthcare analytics, with hands-on exposure to Medicare Advantage Part D measures, PQA specifications, and pharmacy data.

• Proficient in SQL and skilled in building, validating, and QA-ing intricate datasets across claims, pharmacy, eligibility, and vendor sources.

• Evaluated programs, interventions, or vendor performance using structured measurement frameworks — and can relate findings back to business decisions.

• Familiar with CMS Stars, HEDIS, CAHPS, and regulatory requirements, and can navigate BI tools such as Tableau, Looker, Power BI, or Mode.

• Communicate effectively with both technical and non-technical audiences and can convert complex data into actionable insights for stakeholders at various levels.

🏝️ 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 place a high priority on 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 sustaining 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 foster a remote-first culture that encourages collaboration and flexibility, allowing our team members to excel from any location.

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

• Additional Perks: Employee Stock Purchase Plan (ESPP) providing discounted equity opportunities.

• Reimbursement for home office setup costs.

• Monthly stipend for cell phone and internet expenses.

• Remote-first culture, facilitating collaboration with global teams.

• Paid parental leave for all new parents.

• And much more!