Senior Data Analyst

Role Description

We don't just provide health insurance—we deliver the kind of healthcare that people deserve. The Risk Adjustment team at Clover is made up of collaborative and strategic thinkers who are excited about the impact technology can have on healthcare. In this role, you will partner and help support a core area of responsibility for our Risk Adjustment team, helping ensure the accuracy, integrity, and performance of our encounter data and risk adjustment operations. Your work will directly influence revenue accuracy, compliance, and our ability to reinvest in better care for our members.

As a Senior Data Analyst, Risk Adjustment, you will:

• Be responsible for the monitoring and management of the end to end data flow of data submissions to vendors and government agencies to mitigate 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.
• Support the claim and supplemental submission workflow for CMS EDS submissions.
• Collaborate closely between the Engineering and Risk Adjustment teams.
• Assist with, track, and implement risk adjustment related initiatives and strategies.
• Maintain, update, and create policies, procedures, and other documentation around the encounter process.

Success in this role looks like:

• Within the first 90 days: Develop a strong understanding of Clover’s end-to-end CMS EDS submission process, independently monitor data flows to vendors and CMS, identify and resolve encounter data errors, and build effective working relationships across Engineering and Risk Adjustment.
• Within the first 6 months: Own the claim and supplemental submission workflow for CMS EDS submissions, proactively mitigate data leakage and submission errors, enhance tracking and reporting dashboards, and implement process improvements that strengthen data accuracy and operational efficiency.
• Future success: Serve as a trusted technical partner to Risk Adjustment and Engineering, continuously optimize encounter data pipelines and controls, ensure high-quality and compliant CMS submissions, and drive scalable solutions that support accurate risk adjustment performance and business growth.

You should get in touch if:

• You have two years experience with Medicare Risk Adjustment, Centers for Medicare & Medicaid Services (CMS) Encounter Data System (EDS) submissions, and healthcare claims data.
• You have at least two years of programming experience using SQL, Python, and R.
• You have experience with building operational level dashboards.
• You are a self-starter, have a high degree of internal drive and motivation, and desire to execute at a high level.
• You are relentlessly focused on serving the needs of diverse business customers.

Qualifications

• Two years experience with Medicare Risk Adjustment and CMS EDS submissions.
• At least two years of programming experience using SQL, Python, and R.
• Experience with building operational level dashboards.
• Self-starter with high internal drive and motivation.
• Focus on serving diverse business customers.

Requirements

• Strong understanding of Clover’s end-to-end CMS EDS submission process.
• Ability to independently monitor data flows and resolve encounter data errors.
• Proactive in mitigating data leakage and submission errors.
• Capability to enhance tracking and reporting dashboards.
• Experience in implementing process improvements for data accuracy.

Benefits

• Competitive base salary and equity opportunities.
• Performance-based bonus program.
• 401k matching and regular compensation reviews.
• Comprehensive medical, dental, and vision coverage.
• No-Meeting Fridays and monthly company holidays.
• Access to mental health resources and flexible time-off policy.
• Remote-first culture supporting collaboration and flexibility.
• Learning programs, mentorship, and professional development funding.
• Employee Stock Purchase Plan (ESPP) offering discounted equity opportunities.
• Reimbursement for office setup expenses.
• Monthly cell phone & internet stipend.
• Paid parental leave for all new parents.
• And much more!