Job description
At Clover Health, we are committed to providing high-quality, affordable, and easy-to-understand healthcare plans for America’s seniors. We prioritize preventive care while leveraging data and technology through the Clover Assistant, a powerful tool that helps physicians make informed health recommendations. By giving doctors a holistic view of each member’s complete health history, we ensure better care at a lower cost—delivering the highest value to those who need it most.
The MA (Medicare Advantage) Finance Operations Team is focused on measuring, analyzing and providing actionable guidance on the financial performance of Clover Health’s Insurance Segment. Our Data-Driven approach is leveraged by Senior Management, Business Owners and various departments across the Insurance Segment. This Role will be focused on Clinical Programs owned by Clover Health’s Chief Medical Officer such as Utilization Management, Pharmacy Benefit Management and Medicare Star Rating Support. As a Financial Operations Analyst, this role will act as a liaison between the Finance Team and the Clinical Team - both measuring past performance outcomes to the Clinical Business Owners and relaying expected changes to the Financial Forecasting Team.
As a Financial Operations Analyst, you will:
- Use SQL and other data analysis tools to monitor, refine and combine multiple data models centered around Medical Prior Authorizations, Step Therapy reviews and Pharmacy/Medical Claims.
- Develop and maintain complex financial models to project the costs and savings associated with various clinical programs and interventions.
- Prepare detailed reports and presentations for management, highlighting financial performance, clinical program outcomes, and key metrics related to data analysis.
- Support the budgeting and forecasting processes for Medicare Advantage, integrating data-driven insights from clinical program performance to inform financial projections.
- Collaborate with cross-functional teams, including actuarial, claims, clinical, and data science, to address financial issues, support strategic initiatives, and evaluate clinical outcomes.
- Develop and maintain documentation for financial processes and procedures, including detailed protocols for data analysis and clinical program evaluation.
- Provide data-driven analyses on current and prospective vendor return on investment scores.
Success in this role looks like:
- Becoming subject matter expert in all clinical program data models.
- Collaborating with clinical process owners to develop insightful reports used in business decision making.
- Alerting actuarial forecasters of clinical process changes and the expected financial impact.
- Demonstrating financial impact of clinical programs to process owners and executive leadership.
You should get in touch if:
- You are proficient in financial modeling, data visualization, and reporting tools, including advanced Excel, SQL, and data analytics platforms (e.g., Tableau, Power BI, Mode Analytics, R).
- You have a Bachelor’s degree in Finance, Accounting, Data Science, Healthcare Administration, or a related field.
- You have extensive experience in financial analysis, preferably in the healthcare or insurance industry, with a strong background in data analytics.
- You have advanced analytical and problem-solving skills, with expertise in data manipulation and interpretation.
- You have excellent communication and interpersonal skills, with the ability to present complex data findings to diverse audiences.
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.
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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 $$$ to $$$. 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.
