Senior Clinical Data Analyst

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

📋 Description

• Collect requirements from stakeholders and convert them into specific, actionable work tasks.

• Create complex SQL queries to facilitate data-driven insights that guide business and clinical decisions.

• Examine healthcare data (claims, lab, pharmacy, and EMR data) to derive conclusions and provide consultations to stakeholders for administering specific programs and operational processes.

• Generate reports, dashboards, and visualizations that offer insights into diverse patient populations and healthcare utilization trends.

• Collaborate closely with clinical and operational teams to promote data-driven decision-making and aid in evaluating treatment concordant care.

• Assess CCS operations in relation to goals and summarize the completion of routine tasks by various business unit resources.

• Ensure data accuracy, quality, and integrity while working with 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.

⛳️ Requirements

• You possess a BA/BS in Mathematics, Statistics, Economics, Healthcare, or a related field, along with 5+ years of relevant professional experience.

• You demonstrate strong SQL skills with experience in querying, summarizing, and manipulating large healthcare datasets.

• You have practical experience analyzing medical and pharmacy claims data, including medical cost modeling, utilization analysis, trend analysis, and PMPM calculations.

• You are familiar with healthcare actuarial concepts, including risk adjustment methodologies (e.g., HCC, RAF), population risk stratification, and enrollment/eligibility analysis.

• You possess knowledge of healthcare data standards and coding systems (ICD-10, CPT, DRG) and are familiar with healthcare quality measures (e.g., HEDIS, CMS, NCQA), ideally within Medicare Advantage.

• You have the capability to validate data quality, identify anomalies, document analytical assumptions, and conduct member-level longitudinal analyses.

• You exhibit strong communication skills, able to translate complex analytical findings into clear, actionable insights and present them to actuarial, clinical, financial, and operational stakeholders using tools like Excel and data visualization platforms (e.g., Tableau, Power BI).

🏝️ Benefits

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

• Physical Well-Being: We prioritize 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: Recognizing the significance of mental health in enhancing productivity and sustaining work-life balance, we offer initiatives such as No-Meeting Fridays, monthly company holidays, access to mental health resources, and a generous flexible time-off policy. Our remote-first culture fosters collaboration and flexibility, enabling our team members to flourish from any location.

• Professional Development: At Clover, developing internal talent is a priority. We provide 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, facilitating collaboration with global teams.

• Paid parental leave for all new parents.

• And much more!