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Senior Analyst, Medicare Stars (Pharmacy Programs)

1 hour, 35 minutes ago
United States
Full-time
Senior
Business Intelligence Analyst
Data Science and Analytics
Looker Mode Power BI SQL Tableau
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 46

Description

  • Own Part D Stars analytics end to end, including KPI tracking and ROI measurement across pharmacy programs.
  • Design, optimize, and QA SQL-based pipelines and datasets across claims, pharmacy, and vendor sources.
  • Partner with Data Engineering on data architecture, automation, and documentation aligned to CMS, PQA, and internal standards.
  • Analyze Part D Stars measures to identify trends, gaps, and early warning signals.
  • Translate analytical findings into clear recommendations and executive-ready dashboards.
  • Design test-and-learn frameworks to evaluate Stars campaigns, pharmacy interventions, and vendor programs.
  • Define success metrics, run cohort analyses, and apply learnings to future program improvements.
  • Serve as the primary analytics partner for Pharmacy Stars Operations and vendor teams.
  • Work with Product and Engineering to integrate insights into Counterpart Assistant and provider workflows.
  • Establish standardized analytics workflows, SOPs, and intake processes to support scalable performance management.

Requirements

  • 4–6+ years of experience in healthcare analytics.
  • Direct exposure to Medicare Advantage Part D measures, PQA specifications, and pharmacy data.
  • Strong proficiency in SQL.
  • Experience building, validating, and QA-ing complex datasets across claims, pharmacy, eligibility, and vendor sources.
  • Experience evaluating programs, interventions, or vendor performance using structured measurement frameworks.
  • Ability to connect analytical findings back to business decisions.
  • Familiarity with CMS Stars, HEDIS, CAHPS, and regulatory requirements.
  • Experience working with BI tools such as Tableau, Looker, Power BI, or Mode.
  • Ability to communicate clearly with both technical and non-technical audiences.
  • Experience with healthcare analytics in a Medicare/Part D environment is preferred.

Benefits

  • Competitive base salary of $115,000–$133,000 USD.
  • Equity opportunities, including an Employee Stock Purchase Plan (ESPP) with discounted equity.
  • Performance-based bonus program and 401(k) matching.
  • Comprehensive medical, dental, and vision coverage.
  • Flexible time-off policy.
  • Remote-first culture with collaboration and flexibility.
  • Mental health resources, No-Meeting Fridays, and monthly company holidays.
  • Learning programs, mentorship, and professional development funding.
  • 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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