Clover is reinventing health insurance by working to keep people healthier.
We don't just provide health insurancewe deliver the kind of healthcare that people deserve. The Actuarial team at Clover is made up of collaborative & strategic thinkers who are excited about the impact technology can have on healthcare. In this role, you will partner & help support a core area of responsibility for our Actuarial team.
As a Risk Adjustment Actuary, you will:
- Support the monthly close process, including the development of actuarial risk adjusted revenue accruals & analysis of results.
- Oversee & maintain internal CMS HCC & RxHCC models for calculating member level risk scores.
- Builds reports to track ROI on various risk adjustment initiatives.
- Support actuarial teams in the development of risk scores for forecast & bidding purposes.
- Provide analytical support in the optimization of risk adjustment related activities while maintaining compliance with CMS standards.
- Collaborates with internal departments, including but not limited to, Data Science, Finance, Actuarial, Operations, Network Management, & external vendors on risk adjustment activities.
You will love this job if:
- You are passionate about your career in actuarial science & want to demonstrate the value that actuaries can provide in a highly collaborative & cross-functional environment.
- You dream about ways to make the healthcare system more efficient & are excited about the prospect of leveraging modern tools and techniques to do so.
- You are analytical & strategic & love working in a collaborative, transparent work environment.
- You want to make an impact. From project scope to priority to implementation, you'll have an impact on how decisions get made.
You should get in touch if:
- You have achieved, or are near to achieving, the ASA credential.
- You have at least three years of experience in health insurance; Medicare experience is preferred.
- You have an interest in building automated tools around actuarial analysis.
- You have basic programming skills, such as SQL, SAS, R, or Python.
Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest & conviction records. We are an E-Verify company.
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 & analytics to empower our clinical staff to intervene & provide personalized care to the people who need it most.
We always put our members first, & our success as a team is measured by the quality of life of the people we serve. Those who work at Clover are passionate & mission-driven individuals with diverse areas of expertise, working together to solve the most complicated problem in the world: healthcare.
From Clovers inception, Diversity & Inclusion have always been key to our success. We are an Equal Opportunity Employer & our employees are people with different strengths, experiences & backgrounds, who share a passion for improving people's lives. Diversity not only includes race & gender identity, but also age, disability status, veteran status, sexual orientation, religion & many other parts of ones identity. All of our employees points of view are key to our success, & inclusion is everyone's responsibility.