Senior Analyst, Medicare Stars (Pharmacy Programs)

Role Description

Our Part D organization is responsible for creating the most comprehensive and affordable drug plan for Clover Health’s Medicare members. The analytics team is critical within this org. to identify, diagnose and measure how support for members can be improved.

We're looking for a Senior Analyst to own end-to-end analytics for Medicare Part D Stars performance and pharmacy programs. You'll sit at the intersection of data, clinical strategy, and operations — ensuring that insights aren't just accurate and scalable, but actionable and embedded in the workflows that drive real health outcomes.

As a Senior Analyst, you will:

• Own Part D Stars analytics end-to-end.
• Serve as the single-threaded owner for Stars performance, tracking KPIs and ROI across pharmacy programs — ensuring outputs directly inform interventions and business decisions.
• Build and maintain data infrastructure.
• Design, optimize, and QA SQL-based pipelines and datasets across claims, pharmacy, and vendor sources. Partner with Data Engineering on architecture, automation, and documentation aligned to CMS (Centers for Medicare and Medicaid Services), PQA (Pharmacy Quality Alliance), and internal standards.
• Generate and communicate insights.
• Analyze Part D Stars measures to identify trends, gaps, and early warning signals. Translate findings into clear recommendations and build dashboards that support both operational and executive decision-making.
• Evaluate programs and vendors.
• Design test-and-learn frameworks to assess the effectiveness of Stars campaigns, pharmacy interventions, and vendor programs. Define success metrics, run cohort analyses, and apply learnings to future improvements.
• Enable cross-functional partners.
• Act as the primary analytics partner for Pharmacy Stars Operations and vendor teams. Bridge business needs to technical teams, and partner with Product and Engineering to integrate insights into Counterpart Assistant and provider workflows.
• Build operational structure.
• Establish standardized analytics workflows, SOPs, and intake processes. Drive consistent use of measure logic and business rules across teams to support a scalable performance management cadence.

Success in this role looks like:

• First 90 days: You've built a deep understanding of Clover's Part D Stars data landscape, established relationships with key cross-functional partners, and identified the highest-priority gaps in current reporting and pipeline reliability.
• First 6 months: Your analytics infrastructure is meaningfully improved — pipelines are more reliable, dashboards are trusted by operations and leadership, and you've completed at least one test-and-learn evaluation that directly informed a program or vendor decision.
• First year and beyond: You're the go-to owner for Part D Stars analytics, with standardized SOPs, a scalable performance cadence, and measurable contributions to Stars measure performance. You're driving proactive insights — not just reporting — and shaping how Clover uses data to improve health outcomes.

You should get in touch if:

• You have 4–6+ years of experience in healthcare analytics, with direct exposure to Medicare Advantage Part D measures, PQA specifications, and pharmacy data.
• You're proficient in SQL and experienced building, validating, and QA-ing complex datasets across claims, pharmacy, eligibility, and vendor sources.
• You've evaluated programs, interventions, or vendor performance using structured measurement frameworks — and can connect the findings back to business decisions.
• You're familiar with CMS Stars, HEDIS, CAHPS, and regulatory requirements, and can work within BI tools like Tableau, Looker, Power BI, or Mode.
• You communicate clearly across technical and non-technical audiences and can translate complex data into actionable insights for stakeholders at all levels.

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!