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Data Analyst, Value-Based Care Analytics

1 month, 1 week ago
United States
Full-time
Mid Level
Data Analyst
Data Science and Analytics
GCP Python R Snowflake SQL
Apply Now
Clover Health

Clover Health

Clover Health is a data-focused health insurance company that is revolutionizing the Medicare Advantage space by integrating innovative technology into its plans. With a focus on optimizing medical outcomes and reducing costs, Clover Health uses analyt...

Insurance
251-1K
Founded 2014
$925M raised
View All Jobs 23

Description

  • Build and maintain core value-based care performance metrics across risk, quality, utilization, and cost domains, including HCC capture rates, RAF scores, PMPM trends, and inpatient and ED utilization rates.
  • Develop customer-facing analytics, reports, and dashboards that present actionable performance insights in a clear, narrative-driven format.
  • Analyze Medicare Advantage performance data to identify gaps, trends, and opportunities at the patient, provider, and market level.
  • Translate complex analytical findings into executive-ready written summaries, slide-ready visuals, and QBR materials.
  • Conduct deep-dive utilization and cost analyses, including high-cost claimant reviews, avoidable utilization patterns, and specialty and pharmacy spend trends.
  • Partner with Customer Success and Provider Operations teams to prepare and deliver QBRs and monthly reporting packages for customers.
  • Collaborate with Data Engineering to validate claims and clinical data pipelines, flag anomalies, and ensure metric consistency.
  • Contribute to scalable analytics infrastructure through reusable SQL libraries, metric definitions, and documentation.

Requirements

  • 4+ years of hands-on healthcare data analytics experience with direct exposure to payer or provider customers in a value-based care context.
  • Deep familiarity with value-based care metrics, including risk adjustment, HCC coding, RAF scores, utilization, and cost measures.
  • Strong SQL skills with the ability to write complex queries across claims, eligibility, and clinical datasets in cloud-based warehouses such as BigQuery or Snowflake.
  • Exceptional data storytelling ability to translate analytical findings into clear narratives and visuals for clinical and non-technical audiences.
  • Experience building customer-facing reports and dashboards and presenting findings to external stakeholders such as health plans, provider groups, and ACOs.
  • Medicare Advantage experience, including familiarity with CMS risk adjustment models, Star Ratings methodology, and MA quality bonus payment structures, preferred.
  • Familiarity with clinical terminologies such as ICD-10, CPT/HCPCS, NDC, SNOMED, and LOINC, preferred.
  • Experience using Python or R for data manipulation, cohort analysis, or statistical modeling, preferred.
  • Background working with EHR or clinical data alongside claims, preferred.
  • Prior experience in a health plan, risk-bearing provider group, ACO, or health tech company supporting value-based care programs, preferred.

Benefits

  • Competitive base salary of $96,000 to $125,000 USD.
  • Equity opportunities, including an Employee Stock Purchase Plan with discounted equity.
  • Performance-based bonus program and 401(k) matching.
  • Comprehensive medical, dental, and vision coverage.
  • Remote-first culture with flexibility to work from any location.
  • Flexible time-off policy, including No-Meeting Fridays and monthly company holidays.
  • Access to mental health resources and wellness support.
  • Learning programs, mentorship, professional development funding, and regular performance feedback.
  • Paid parental leave for all new parents.
  • Reimbursement for office setup expenses and a monthly cell phone and internet stipend.

Interested in this position?

Apply directly on the company website

Apply Now

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