Medicare Stars Analytics Manager

Clover is reinventing health insurance by working to keep people healthier.

The Actuarial team at Clover Health is a group of tech-savvy, collaborative, and strategic thinkers driven by a shared enthusiasm for the transformative power of technology in healthcare. With a blend of analytical prowess, industry knowledge, and a passion for improving healthcare outcomes, the Actuarial team plays a pivotal role in guiding decision-making processes and ensuring the long-term sustainability of our Medicare Advantage initiatives.

We are seeking a Medicare Stars Analytics Manager with a profound understanding of Medicare Stars complemented with strong technical prowess. In this pivotal role, you'll spearhead the development of dashboards and insightful reports crucial for gauging the impact and success of our initiatives. Serving as the go-to subject matter expert, you'll delve deep into data on Stars quality measures, extracting invaluable insights to inform strategic decision-making. Through your contributions, you'll actively propel Clover's mission of improving every life forward through data-driven innovation.

As a Medicare Stars Analytics Manager, you will:

• Become the authority on Stars-related reporting by developing and maintaining in-depth analytics, including reports and dashboards, for Medicare Stars performance.
• Identify at-risk members and transform insights into actionable strategies, fostering ongoing quality enhancement.
• Collaborate with cross-functional teams including Actuarial, Product, Clinical Programs, Finance, Operations, Claims, and Network Management to devise and analyze quality-based payment models aligned with Stars outcomes.
• Make an impact by defining critical metrics and KPIs to shape strategic initiatives aimed at elevating our overall Stars ratings.
• Analyze data, clinical outcomes, Stars quality measures and present relevant strategies with analytical evidence to the leadership team.
• Assess the effectiveness of current initiatives and pilot programs, using cut point projections and sensitivity analyses to forecast their impact on our ratings.

Success in this role looks like:

• Within your first 90 days, you’ve taken on full ownership and responsibility of Stars Analytics by developing tools to enable success in measuring and forecasting Stars performance. You have demonstrated a deep understanding of key goals and metrics for the Clover Stars program.
• Within your first 6 months, you'll have initiated the process of providing valuable insights and recommendations for program enhancement, distinguishing successful initiatives from those falling short of their intended impact. Your contribution will extend to the design and development of comprehensive analytics, reports, and dashboards to monitor Stars measures effectively.
• Future success in this role will be measured by your continuous ability to gather Stars reporting data, analyze CMS changes, and collaborate with Stars leads to set strategic direction. You will continue to demonstrate the ability to collaborate and build strong partnerships with internal stakeholders to evaluate the efficacy of current operational metrics and as needed craft new Stars metrics to more accurately gauge the organization's performance to elevate Stars ratings.

Youshould get in touch if:

• You have 5+ years of relevant experience working with CMS Stars Ratings measures.
• You have a passion for data analytics and enjoy translating insights into strategies to improve health outcomes and elevate Stars ratings.
• You have a deep knowledge and technical expertise of the Stars Rating technical notes and methodology, validation of plan preview metrics, and regulatory and industry changes and trends.
• You have advanced skills in regard to data manipulation, programming languages (SAS, SQL, or R), and in creating and maintaining analytical dashboards and reports.
• You are a self-starter with superb attention to detail, have a high degree of internal drive and motivation, and desire to execute at a high level.
• You have a research mindset. You're not afraid of the unknown and love thinking “outside of the box”.

Clover 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, company holidays, access to mental health resources, and a generous flexible time-off policy.
• Professional Development: We are committed to developing our internal talent. 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.

Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records. We are an E-Verify company.

A reasonable estimate of the base salary range for this role is $122,000 to $187,000. Final pay is based on several factors including but not limited to internal equity, market data, and the applicant’s education, work experience, certifications, etc.

About Clover: We are reinventing health insurance by combining the power of data with human empathy to keep our members healthier. We believe the healthcare system is broken, so we've created custom software and analytics to empower our clinical staff to intervene and provide personalized care to the people who need it most.

We always put our members first, and our success as a team is measured by the quality of life of the people we serve. Those who work at Clover are passionate and mission-driven individuals with diverse areas of expertise, working together to solve the most complicated problem in the world: healthcare.

From Clover’s inception, Diversity & Inclusion have always been key to our success. We are an Equal Opportunity Employer and our employees are people with different strengths, experiences and backgrounds, who share a passion for improving people's lives. Diversity not only includes race and gender identity, but also age, disability status, veteran status, sexual orientation, religion and many other parts of one’s identity. All of our employee’s points of view are key to our success, and inclusion is everyone's responsibility.