Senior Actuarial Analyst

🕒 April 13

🇺🇸 United States – Remote

💵 $108k - $132k / year

⏰ Full Time

🟠 Senior

📊 Actuary

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Clover Health

WebsiteLinkedInAll Job Openings

501 - 1000 employees

Clover Health (Nasdaq: CLOV) is a physician enablement company focused on seniors who have historically lacked access to affordable, high-quality healthcareWe aim to provide great care, in a sustainable way, by having a business model built around improving medical outcomes while lowering avoidable costs. We do this while taking a holistic approach to understanding the health needs and social risk factors of those under our care. This strategy is underpinned by our proprietary software platform, the Clover Assistant, which is designed to aggregate patient data from across the health ecosystem to support clinical decision-making by presenting physicians and other providers with real-time, personalized recommendations at the point of care.Making care more accessible is at the heart of our business, and we believe patients should have the freedom to choose their doctors. We offer affordable Medicare Advantage plans with extensive benefits, provide primary care physicians with the Clover Assistant, and also make comprehensive home-based care available via the Clover Home Care program.With our corporate headquarters in Nashville, Clover’s workforce is distributed around the U.S. and also includes a team of world-class technologists based in Hong Kong. We manage care for Medicare Advantage members in Alabama, Arizona, Georgia, Mississippi, New Jersey, Pennsylvania, South Carolina, Tennessee, and Texas.We are hiring software engineers, data scientists, designers and product folks who can help us understand our members’ wellness and steer them clear of any health risks down the road.If you’re a passionate person and interested in changing healthcare for the better, then Clover Health may just be the place for you.

📋 Description

• Maintain internal CMS HCC and RxHCC models for calculating member level risk scores. • Support the monthly close process, including the development of actuarial risk adjusted revenue accruals and analysis of results. • Build reports to track ROI on various risk adjustment initiatives. • Support actuarial teams in the development of risk scores for forecast and bidding purposes. • Provide actuarial support on risk adjustment, pricing, forecasting, reserving, trend analysis, and value-based care. • Communicate analysis, findings, and supporting data to leadership and partnering teams. • Build automated actuarial tools and data pipelines. • Support compliance under Sarbanes Oxley, including through process and tool design, peer review and control testing. • Be accountable for key work products under supervision of experienced actuaries. • Collaborate with internal departments and external vendors on risk adjustment activities.

🎯 Requirements

• At least one year experience in health insurance; Medicare experience is preferred. • Completed at least two actuarial exams. • Interest in building automated tools around actuarial analysis and experience building analytic dashboards. • Self-starter with a high degree of internal drive and motivation. • Two years experience with Medicare Risk Adjustment, CMS EDS submissions, and healthcare claims data. • At least two years of programming experience including SQL, R, Python, SAS, VBA.

🏖️ Benefits

• Our commitment to attracting and retaining top talent begins with a competitive base salary and equity opportunities. • Performance-based bonus program. • 401k matching. • Regular compensation reviews to recognize and reward exceptional contributions. • Comprehensive medical, dental, and vision coverage. • Initiatives such as No-Meeting Fridays, monthly company holidays, access to mental health resources, and a generous flexible time-off policy. • Remote-first culture that supports collaboration and flexibility. • Learning programs, mentorship, professional development funding, and regular performance feedback and reviews. • 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.