Clinical Data Analyst

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 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. You must be a data-driven, highly analytical problem-solver with exceptional organizational skills, and passionate about our mission.

As a Clinical Data Analyst, you will:

• Gather 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 of data report requests.
• 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:

• A BA/BS in Mathematics, Statistics, Economics, Healthcare or other related discipline (required).
• 5+ years of relevant, professional work experience (required).
• Proficiency in SQL and are able to query, summarize, and manipulate data (required).
• Experience working with healthcare data including but not limited to claims, lab results and pharmacy data.
• Knowledge of healthcare coding systems (ICD-10, CPT, DRG) and familiarity with healthcare quality measures (e.g., HEDIS, CMS, NCQA).
• Advanced MS Office skills (Excel, Word, PowerPoint, Outlook), with a strong emphasis on Excel (required).
• Experience preparing and presenting data and dashboards using data visualization tools (Tableau, PowerBI).

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 mai