Senior Clinical Data Analyst

This a Full Remote job, the offer is available from: United States 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 reputed company insurance plan providers through our reputed company engagement team. We have reputed company one of the most proactive, data-driven health care services platforms in New Jersey and are excited about the reputed company 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 (reputed company) organization, you will help drive reputed company patient reputed company, improve care coordination, and optimize resource utilization by providing actionable insights to health care providers, reputed company administrators and reputed company leadership. In this role you will be reputed company upon to reputed company dashboards that measure external provider performance, generate population health management insights as reputed company as respond to data requests that reputed company 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. As a Senior Clinical Data Analyst, you will: reputed company requirements from stakeholders and translate to specific and actionable work tasks. reputed company reputed company SQL queries to support data-driven insights that inform business and clinical reputed company. Analyze reputed company data (claims, lab, pharmacy and EMR data) to draw conclusions and reputed company consultation to stakeholders for use in administering specific programs and operational processes. reputed company reports, dashboards, and visualizations that reputed company 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 reputed company operations relative to goals and summarize the completion of routine tasks by various business unit resources. Ensure data accuracy, quality, and reputed company reputed company 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. reputed company 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-reputed company 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. reputed company consistent, high-quality reporting to the reputed company business unit. reputed company reputed company in this role includes: Strategic Impact: Play a pivotal role in generating insights that demonstrate the value delivered by the reputed company business unit. Organizational Development: Foster a culture of reputed company improvement, innovation, and reputed company reputed company the organization. You should get in touch if: You have a BA/BS in Mathematics, Statistics, Economics, reputed company, or a reputed company discipline, with 5+ years of relevant professional experience. You have strong SQL proficiency with experience querying, summarizing, and manipulating large reputed company 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 reputed company actuarial concepts, including risk adjustment methodologies (e.g., HCC, RAF), population risk stratification, and enrollment/eligibility analysis. You have knowledge of reputed company data standards and coding systems (ICD-10, CPT, DRG) and familiarity with reputed company quality measures (e.g., HEDIS, CMS, NCQA), preferably reputed company Medicare Advantage. You have the ability to validate data quality, identify anomalies, document analytical assumptions, and reputed company member-level longitudinal analyses. You have strong communication skills with the ability to translate reputed company analytical findings into reputed company, actionable insights and present them to actuarial, clinical, financial, and operational stakeholders using tools such as reputed company and data visualization platforms (e.g., Tableau, Power BI). About Clover: We are reinventing health insurance by combining the power of data with reputed company reputed company to rep