The Clover Care Services organization delivers proactive support and care to our members through our Clover Home Care teams, and quality improvement services to our aligned insurance plan providers through our practice engagement team. We have built one of the most proactive, data-driven health care services platforms in New Jersey and are excited about the future of technology and how it impacts our ability to bring transformative results to both patients and providers. As a Senior Clinical Data Analyst in the Clover Care Services (CCS) organization, you will help drive better patient outcomes, improve care coordination, and optimize resource utilization by providing actionable insights to health care providers, practice administrators and CCS leadership.

In this role you will be called upon to develop dashboards that measure external provider performance, generate population health management insights as well as respond to data requests that provide an operational perspective relative to business unit OKRs. The right person must be a data-driven, highly analytical problem-solver with exceptional organizational skills, and passionate about our mission.

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. Success in this role looks like: In your first 90 days, you will: Learn the intricacies of the various data sets available to measure Clover Care Services business initiatives.

Successfully build and deliver on a few high-priority data reporting requests. Create a ticketing infrastructure for the intake data report request. After 6 months you will: Partner with stakeholders to analyze, design, and implement approaches to measure external and internal provider performance.

Provide consistent, high-quality reporting to the CCS business unit. Future success in this role includes: Strategic Impact: Play a pivotal role in generating insights that demonstrate the value delivered by the CCS business unit. Organizational Development: Foster a culture of continuous improvement, innovation, and excellence within the organization.

You should get in touch if: 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.

, HCC, RAF), population risk stratification, and enrollment/eligibility analysis. , HEDIS, CMS, NCQA), preferably within Medicare Advantage.