Senior Actuarial Analyst

3 months ago
Full-time
Senior
Data Science and Analytics
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

Description

  • Maintain internal CMS HCC and RxHCC models used to calculate member-level risk scores.
  • Support the monthly close process, including actuarial risk-adjusted revenue accruals and results analysis.
  • Build reports to track ROI for risk adjustment initiatives.
  • Support risk score development for forecasting and bidding purposes.
  • Provide actuarial support across risk adjustment, pricing, forecasting, reserving, trend analysis, and value-based care.
  • Communicate analyses, findings, and supporting data to leadership and partner teams.
  • Build automated actuarial tools and data pipelines.
  • Support Sarbanes-Oxley compliance through process and tool design, peer review, and control testing.
  • Own key work products under the supervision of experienced actuaries.
  • Collaborate with internal teams and external vendors on risk adjustment activities.

Requirements

  • At least 1 year of experience in health insurance; Medicare experience is preferred.
  • Completed at least 2 actuarial exams.
  • At least 2 years of experience with Medicare Risk Adjustment, CMS EDS submissions, and healthcare claims data.
  • At least 2 years of programming experience in SQL, R, Python, SAS, VBA, or similar tools.
  • Experience building automated tools around actuarial analysis and analytic dashboards.
  • Self-starter with a high degree of internal drive, motivation, and ability to execute at a high level.
  • Eligible to participate in Clover's Actuarial Student Program.
  • Experience with CMS HCC and RxHCC models is expected for success in the role.
  • Education, certifications, and work experience may be considered in final pay decisions.
  • Final salary is based on internal equity, market data, education, work experience, and certifications.

Benefits

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

Interested in this position?

Apply directly on the company website

Apply Now

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