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Senior Data Analyst, Risk Adjustment

2 hours, 13 minutes ago
United States
Full-time
Junior
Data Analyst
Data Science and Analytics
Python R 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 22

Description

  • Monitor and manage the end-to-end data flow for submissions to vendors and government agencies to reduce data leakage and submission errors.
  • Own the claim and supplemental submission workflow for Centers for Medicare & Medicaid Services (CMS) Encounter Data System (EDS) submissions.
  • Develop data pipeline tracking reports and analyze, research, and resolve encounter data errors.
  • Collaborate closely with Engineering and Risk Adjustment teams to support operational and technical initiatives.
  • Assist with tracking and implementing risk adjustment-related initiatives and strategies.
  • Maintain, update, and create policies, procedures, and other documentation for the encounter process.
  • Improve tracking, reporting, and controls to strengthen data quality and operational efficiency.
  • Serve as a technical partner to help optimize encounter data pipelines and CMS submission processes.

Requirements

  • 2+ years of experience with Medicare Risk Adjustment, CMS Encounter Data System (EDS) submissions, and healthcare claims data.
  • 2+ years of programming experience using SQL, Python, and R.
  • Experience building operational-level dashboards.
  • Self-starter with strong internal drive and motivation to execute at a high level.
  • Strong focus on serving the needs of diverse business customers.
  • Experience working at the intersection of engineering, analytics, and operations in a regulated environment (preferred).
  • Ability to identify and resolve data quality and submission issues (preferred).
  • Education, work experience, and certifications may be considered in final compensation decisions.

Benefits

  • Competitive base salary of $76,900 to $100,000 USD.
  • Equity opportunities, including Employee Stock Purchase Plan (ESPP).
  • Performance-based bonus program and 401(k) matching.
  • Comprehensive medical, dental, and vision coverage.
  • Flexible time-off policy and monthly company holidays.
  • Remote-first culture with collaboration flexibility.
  • Access to mental health resources and No-Meeting Fridays.
  • Learning programs, mentorship, professional development funding, and paid parental leave.

Interested in this position?

Apply directly on the company website

Apply Now

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