Senior Analyst, Part D Spend

Our Part D organization is focused on optimizing pharmacy spend while improving clinical outcomes for Clover Health’s Medicare members. The analytics team plays a critical role in ensuring that clinical management programs are measurable, scalable, and effective in driving both cost and quality performance.

We're looking for a Senior Analyst to own end-to-end analytics for Part D Spend performance and clinical engagement programs. You'll sit at the intersection of data, clinical strategy, and operations — ensuring that insights aren't just accurate and scalable, but actionable and embedded in the workflows that drive real health outcomes and cost optimization.

As a Senior Analyst, you will:

• Own Part D clinical engagement and spend analytics end-to-end. Serve as the single-threaded owner for clinical management program performance, tracking KPIs and ROI for pharmacy spend optimization — ensuring outputs directly inform interventions, provider actions, and business decisions.
• Build and maintain data infrastructure. Design, optimize, and QA SQL-based pipelines and datasets across claims, pharmacy, and vendor sources. Partner with Data Engineering on architecture, automation, and documentation aligned to CMS (Centers for Medicare and Medicaid Services), PQA (Pharmacy Quality Alliance), and internal standards.
• Generate and communicate insights. Analyze Part D performance and clinical interventions to identify trends, gaps, and early warning signals. Conduct root cause analyses across adherence, prescribing behavior, and specialty drug utilization. Translate findings into clear recommendations and build dashboards that support both operational and executive decision-making.
• Evaluate programs and vendors. Design test-and-learn frameworks to assess the effectiveness of pharmacy interventions, clinical programs, and vendor initiatives. Define success metrics, run cohort analyses, and apply learnings to future improvements.
• Enable cross-functional partners. Act as the primary analytics partner for Part D spend management operations and vendor teams. Bridge business needs to technical teams, and partner with Product and Engineering to integrate insights into Counterpart Assistant and provider workflows.
• Build operational structure. Establish standardized analytics workflows, SOPs, and intake processes. Drive consistent use of measure logic and business rules across teams to support a scalable performance management cadence.
• Drive technology and automation. Support initiatives to improve prescribing interoperability, real-time visibility, and automation of intervention tracking and performance monitoring.

Success in this role looks like:

• First 90 days: You've built a deep understanding of Clover's Part D clinical management data landscape, established relationships with key cross-functional partners, and identified the highest-priority gaps in current reporting, pipeline reliability, and intervention tracking.
• First 6 months: Your analytics infrastructure is meaningfully improved — pipelines are more reliable, data is validated and trusted, and you've completed at least one test-and-learn evaluation that directly informed a clinical program or vendor decision.
• First year and beyond: You're the go-to owner for Part D clinical engagement and spend analytics, with standardized SOPs, a scalable performance cadence, and measurable contributions to pharmacy cost optimization and quality performance. You're driving proactive insights — not just reporting — and shaping how Clover uses data to improve health outcomes and manage spend.

You should get in touch if:

• You have 4–6+ years of experience in healthcare analytics, with direct exposure to Part D / pharmacy data, clinical data and sources for appropriate therapeutic substitutions.
• You're proficient in SQL and experienced building, validating, and QA-ing complex datasets across claims, pharmacy, eligibility, clinical documentation, and vendor sources.
• You've performed both backend data QA and business-facing analytics, and can connect findings to program performance and operational decisions.
• You have experience evaluating interventions, clinical programs, or vendor performance using structured measurement frameworks.
• You're familiar with clinical best practices, regulatory and commercially available data sets (e.g., FDB, RxNorm, MediSpan, FDA), regulatory requirements, and can work within BI tools like Tableau, Looker, Power BI, or Mode.
• You communicate clearly across technical and non-technical audiences and can translate complex data into actionable insights for stakeholders at all levels.

Bonus:

• Experience with specialty pharmacy or pharmacogenomics programs
• Exposure to provider-facing tools (e.g., EHRs)
• Experience in value-based care or cost-of-care analytics

Benefits Overview:

• 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, monthly company holidays, access to mental health resources, and a generous flexible time-off policy. Additionally, we embrace a remote-first culture that supports collaboration and flexibility, allowing our team members to thrive from any location.
• Professional Development: Developing internal talent is a priority for Clover. 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
• Paid parental leave for all new parents
• And much more!

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, perspectives, opinions, 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.

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