Senior Clinical Data Analyst

Role Description

As a Senior Clinical Data Analyst in the Clover Care Services (CCS) organization, you will help drive better patient outcomes, improve care coordination, and optimize resource utilization by providing actionable insights to health care providers, practice administrators, and CCS leadership. In this role, you will be called upon to develop dashboards that measure external provider performance, generate population health management insights, as well as respond to data requests that provide an operational perspective relative to business unit OKRs.

The right person must be a data-driven, highly analytical problem-solver with exceptional organizational skills, and passionate about our mission.

• Gather requirements from stakeholders and translate to specific and actionable work tasks.
• Develop complex SQL queries to support data-driven insights that inform business and clinical decisions.
• Analyze healthcare data (claims, lab, pharmacy, and EMR data) to draw conclusions and provide consultation to stakeholders for use in administering specific programs and operational processes.
• Develop reports, dashboards, and visualizations that provide insights into various patient populations and health care utilization patterns.
• Partner closely with clinical and operational teams to ensure data-driven decision-making and assist in the assessment of treatment concordant care.
• Analyze CCS operations relative to goals and summarize the completion of routine tasks by various business unit resources.
• Ensure data accuracy, quality, and integrity when working across multiple data sets.
• Prepare and present findings and recommendations to leadership, internal clinical teams, and external stakeholders in support of Clover Care Services business initiatives.

Success in this role looks like:

• In your first 90 days, you will:
• Learn the intricacies of the various data sets available to measure Clover Care Services business initiatives.
• Successfully build and deliver on a few high-priority data reporting requests.
• Create a ticketing infrastructure for the intake data report request.
• After 6 months you will:
• Partner with stakeholders to analyze, design, and implement approaches to measure external and internal provider performance.
• Provide consistent, high-quality reporting to the CCS business unit.
• Future success in this role includes:
• Strategic Impact: Play a pivotal role in generating insights that demonstrate the value delivered by the CCS business unit.
• Organizational Development: Foster a culture of continuous improvement, innovation, and excellence within the organization.

Qualifications

• You have a BA/BS in Mathematics, Statistics, Economics, Healthcare, or a related discipline, with 5+ years of relevant professional experience.
• You have strong SQL proficiency with experience querying, summarizing, and manipulating large healthcare datasets.
• You have hands-on experience analyzing medical and pharmacy claims data, including medical cost modeling, utilization analysis, trend analysis, and PMPM calculations.
• You have experience with healthcare actuarial concepts, including risk adjustment methodologies (e.g., HCC, RAF), population risk stratification, and enrollment/eligibility analysis.
• You have knowledge of healthcare data standards and coding systems (ICD-10, CPT, DRG) and familiarity with healthcare quality measures (e.g., HEDIS, CMS, NCQA), preferably within Medicare Advantage.
• You have the ability to validate data quality, identify anomalies, document analytical assumptions, and perform member-level longitudinal analyses.
• You have strong communication skills with the ability to translate complex analytical findings into clear, actionable insights and present them to actuarial, clinical, financial, and operational stakeholders using tools such as Excel and data visualization platforms (e.g., Tableau, Power BI).

Benefits

• Financial Well-Being: Competitive base salary and equity opportunities, performance-based bonus program, 401k matching, and regular compensation reviews.
• Physical Well-Being: Comprehensive medical, dental, and vision coverage.
• Mental Well-Being: Initiatives such as No-Meeting Fridays, monthly company holidays, access to mental health resources, and a generous flexible time-off policy.
• Professional Development: Learning programs, mentorship, professional development funding, and regular performance feedback and reviews.
• Additional Perks: Employee Stock Purchase Plan (ESPP), reimbursement for office setup expenses, monthly cell phone & internet stipend, remote-first culture, paid parental leave for all new parents, and much more!