Data Analyst, Value-Based Care Analytics

🕒 June 6

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Clover Health

501 - 1000 employees

🏥 Healthcare

🛡️ Insurance

🤖 Artificial Intelligence

Healthcare • Insurance • Artificial Intelligence

Clover Health is a healthcare technology company helping members live their healthiest lives with our Medicare Advantage plans. Focused on seniors who have historically lacked access to affordable and high-quality healthcare, Clover aims to provide care sustainably by improving medical outcomes while simultaneously lowering avoidable costs. They leverage a proprietary software platform, the Clover Assistant, to aggregate patient data and offer real-time recommendations to healthcare providers. Their services include affordable Medicare Advantage plans, a home care program, and they manage care for Medicare Advantage members across several U. S. states.

📋 Description

• Build and maintain core Value-Based Care (VBC) performance metrics across risk, quality, utilization, and cost domains, including HCC capture rates, RAF scores, PMPM trends, and inpatient/ED utilization rates. • Develop customer-facing analytics, reports, and dashboards that surface actionable performance insights for payer and provider partners in a clear, narrative-driven format. • Analyze Medicare Advantage performance data, including risk adjustment, quality bonus payments, and benchmark performance, to identify gaps, trends, and opportunities at the patient, provider, and market level. • Translate complex data findings into executive-ready narratives: written summaries, slide-ready visuals, and structured QBR materials that tell a coherent story about performance and next steps. • Conduct deep-dive utilization and cost analyses, including high-cost claimant reviews, avoidable utilization patterns, and specialty/pharmacy spend trends, to identify levers for improvement. • Partner with Customer Success and Provider Operations teams to prepare and deliver performance reviews (QBRs, monthly reporting packages) that communicate value and surface priority action areas for each customer. • Collaborate with Data Engineering to validate claims and clinical data pipelines, flag anomalies, and ensure metric consistency across customer populations. • Contribute to the development of scalable analytics infrastructure: reusable SQL libraries, metric definitions, and documentation that enable the team to move faster.

🎯 Requirements

• 4+ years of hands-on healthcare data analytics experience, with direct exposure to payer or provider customers in a value-based care context. • Deep familiarity with VBC metrics: risk adjustment (HCC coding, RAF scores), utilization (IP admissions, ED visits, readmissions), and cost (PMPM, total cost of care, benchmark vs. actual). • Strong SQL skills, able to write complex queries across claims, eligibility, and clinical datasets in cloud-based warehouses (BigQuery, Snowflake, or similar). • Exceptional data storytelling ability: you can translate analytical findings into clear narratives and visuals that resonate with both clinical and non-technical audiences. • Experience building customer-facing reports and dashboards; comfortable presenting findings to external stakeholders (health plans, provider groups, ACOs).

🏖️ Benefits

• 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!

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