Clover is reinventing health insurance by working to keep people healthier.
The Clinical Programs team is responsible for ensuring patients have access to the right care at the right time, in the right setting. We collaborate with a cross functional group of clinical, operations & technology teams to deliver personalized care to our members.
Clover's Star rating is a critical barometer of the company's health, indicating how well we're helping our members achieve better health outcomes & how well we're functioning as a business. Our Stars rating also has a significant impact on the company's revenue & ability to offer better insurance benefits & higher touch care.
In this role, you'll support & drive Stars strategy via analytics in play a key role in Stars Leadership at Clover. Develop contract level reporting for interventions & tracking projected rates that support the corporate Stars strategy. Collaborate with operations, data science & technology to ensure sources of data are accounted for in the final year projections. Develop domain & metric executive dashboards. Measure success of interventions as it relates to Stars performance. You will develop reporting & analysis that will lead to improved performance with clinical Stars measures (HEDIS & Part D). Through partnerships with key peers, you'll also ensure the organization is increasing performing across CAHPS, HOS, HEDIS, Part D & Administrative measures. You will also be responsible for company-wide Stars analytics & reporting.
As an Operations Analyst, Stars Strategy you will:
- Collaborate with Head of Stars Strategy & Manager, Stars Strategy on strategic initiatives, key performance indicators & domain drivers
- Develop & maintain Star measure performances & projection tools
- Collaborate with metric & domain leadership to ensure accuracy
- Provide analysis for Stars request for information from CMS, NCQA, PQA & internal teams
- Provide executive reporting for reports & analysis they develop
- Perform analysis of initiatives to determine effectiveness as it relates to Star Ratings
- Report performance & escalate issues & barriers to leadership
- Collaborate across informally connected teams to accomplish goals
- Connect data & information from disparate sources to identify root causes of performance problems
You will love this job if:
- You use creative strategy to help solve complex problems
- You like to dig in & have exceptional research capabilities
- You are highly organized, efficient & demonstrate superior attention to detail
- You are nimble, & comfortable working in a constantly evolving environment. You embrace ambiguity & speed while maintaining a bias towards action
- You are passionate & driven by Clover's mission. You are excited to create a significant impact on member experience & the business
You should get in touch if:
- You have at least 3 years of MAPD Star Analytics experience
- You have strong analytical skills & are an expert in Excel & SQL
- You have strong verbal & written communication & interpersonal skills
- You have an understanding of Stars strategy and/or experience working on related programs
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.