Senior Clinical Data Analyst

🕒 Abril 30

🇺🇸 Estados Unidos – Remoto (EUA)

💵 $115.000 - $133.000 / ano

⏰ Tempo Integral

🟠 Sênior

📉 Analista de Dados

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Clover Health

SiteLinkedInTodas as Vagas

501 - 1000 funcionários

A Clover Health (Nasdaq: CLOV) é uma empresa de capacitação de médicos focada em idosos que historicamente tiveram dificuldade de acesso a um sistema de saúde de alta qualidade e a preços acessíveis. Nosso objetivo é oferecer um atendimento excelente, de forma sustentável, com um modelo de negócios voltado para melhorar os resultados médicos, reduzindo custos evitáveis. Fazemos isso adotando uma abordagem holística para entender as necessidades de saúde e os fatores de risco social dos que estão sob nosso cuidado. Essa estratégia é sustentada pela nossa plataforma de software proprietária, o Clover Assistant, projetada para agregar dados de pacientes de todo o ecossistema de saúde para apoiar a tomada de decisões clínicas, apresentando aos médicos e outros prestadores recomendações personalizadas em tempo real no ponto de atendimento. Tornar o atendimento mais acessível está no coração do nosso negócio, e acreditamos que os pacientes devem ter a liberdade de escolher seus médicos. Oferecemos planos acessíveis do Medicare Advantage com amplos benefícios, fornecemos aos médicos de atenção primária o Clover Assistant e também disponibilizamos um atendimento abrangente em casa através do programa Clover Home Care. Com a nossa sede corporativa em Nashville, a força de trabalho da Clover está distribuída por todo os EUA e também inclui uma equipe de tecnólogos de classe mundial sediada em Hong Kong. Gerenciamos o cuidado para membros do Medicare Advantage no Alabama, Arizona, Geórgia, Mississippi, Nova Jersey, Pensilvânia, Carolina do Sul, Tennessee e Texas. Estamos contratando engenheiros de software, cientistas de dados, designers e profissionais de produto que possam nos ajudar a entender o bem-estar dos nossos membros e mantê-los longe de quaisquer riscos de saúde no futuro. Se você é uma pessoa apaixonada e interessada em mudar o sistema de saúde para melhor, então a Clover Health pode ser o lugar certo para você.

Descrição

• 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.

🎯 Requisitos

• 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).

🏖️ Benefícios

• Financial Well-Being: Our commitment to attracting and retaining top talent begins with a competitive base salary and equity opportunities. Additionally, we offer a performance-based bonus program, 401k matching, and regular compensation reviews to recognize and reward exceptional contributions. • Physical Well-Being: We prioritize the health and well-being of our employees and their families by providing comprehensive medical, dental, and vision coverage. Your health matters to us, and we invest in ensuring you have access to quality healthcare. • Mental Well-Being: We understand the importance of mental health in fostering productivity and maintaining work-life balance. To support this, we offer initiatives such as No-Meeting Fridays, monthly company holidays, access to mental health resources, and a generous flexible time-off policy. Additionally, we embrace a remote-first culture that supports collaboration and flexibility, allowing our team members to thrive from any location. • Professional Development: Developing internal talent is a priority for Clover. We offer learning programs, mentorship, professional development funding, and regular performance feedback and reviews. • Additional Perks: Employee Stock Purchase Plan (ESPP) offering discounted equity opportunities • Reimbursement for office setup expenses • Monthly cell phone & internet stipend • Remote-first culture, enabling collaboration with global teams • Paid parental leave for all new parents • And much more!