Clover Health · 1 week ago
Data Analyst, Value-Based Care Analytics
United States
Full-time
Remote
Mid Level
$96K/yr - $125K/yr
4+ years expClover Health is an AI-powered physician enablement platform that delivers clinical insights to providers at the point of care. The Data Analyst role focuses on translating complex clinical and financial data into actionable insights for payer and provider partners, while building and maintaining performance metrics in value-based care.
HealthcareHealth InsuranceHospitalHealth CareMedical
No H1B
Responsibilities
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
Qualification
Required
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)
Preferred
Medicare Advantage experience, including familiarity with CMS risk adjustment models (CMS-HCC v24/v28), Star Ratings methodology, and MA quality bonus payment structures
Familiarity with clinical terminologies: ICD-10, CPT/HCPCS, NDC, SNOMED, LOINC
Experience using Python or R for data manipulation, cohort analysis, or statistical modeling
Background working with EHR or clinical data alongside claims (e.g., for care gap closure, chronic condition identification, or attribution logic)
Prior experience in a health plan, risk-bearing provider group, ACO, or health tech company supporting VBC programs
Benefits
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
No-Meeting Fridays
Monthly company holidays
Access to mental health resources
Generous flexible time-off policy
Remote-first culture that supports collaboration and flexibility
Learning programs
Mentorship
Professional development funding
Regular performance feedback and reviews
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
Company
Clover Health
Clover is a healthcare technology company helping members live their healthiest lives with its Medicare Advantage plans.
501-1000 employees
Funding
Current Stage
Public CompanyTotal Funding
$1.62BKey Investors
GreenoaksSequoia CapitalFirst Round Capital
2021-11-17Post Ipo Equity· $300M
2021-01-08Post Ipo Equity· $400M
2021-01-08IPO
Leadership Team
Andrew Toy
Chief Executive Officer and Board Member (NASDAQ : CLOV)
Joe Brand
Chief Operating Officer, Medicare Advantage @ Clover Health
Recent News
MedCity News
2026-06-30
2026-06-18
Bizjournals.com Feed (2025-11-12 15:43:17)
2026-06-17
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