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 and 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 and how well we're functioning as a business. Our Stars rating also has a significant impact on the company's revenue and ability to offer better insurance benefits and higher touch care.
In this role, you'll support and drive Stars strategy via analytics in play a key role in Stars Leadership at Clover. Develop contract level reporting for interventions and tracking projected rates that support the corporate Stars strategy. Collaborate with operations, data science and technology to ensure sources of data are accounted for in the final year projections. Develop domain and metric executive dashboards. Measure success of interventions as it relates to Stars performance. You will develop reporting and analysis that will lead to improved performance with clinical Stars measures (HEDIS and Part D). Through partnerships with key peers, you'll also ensure the organization is increasing performing across CAHPS, HOS, HEDIS, Part D and Administrative measures. You will also be responsible for company-wide Stars analytics and reporting.
As an Operations Analyst, Stars Strategy you will:
- Collaborate with Head of Stars Strategy and Manager, Stars Strategy on strategic initiatives, key performance indicators and domain drivers
- Develop and maintain Star measure performances and projection tools
- Collaborate with metric and domain leadership to ensure accuracy
- Provide analysis for Stars request for information from CMS, NCQA, PQA and internal teams
- Provide executive reporting for reports and analysis they develop
- Perform analysis of initiatives to determine effectiveness as it relates to Star Ratings
- Report performance and escalate issues and barriers to leadership
- Collaborate across informally connected teams to accomplish goals
- Connect data and 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 and have exceptional research capabilities
- You are highly organized, efficient and demonstrate superior attention to detail
- You are nimble, and comfortable working in a constantly evolving environment. You embrace ambiguity and speed while maintaining a bias towards action
- You are passionate and driven by Clover's mission. You are excited to create a significant impact on member experience and the business
You should get in touch if:
- You have at least 3 years of MAPD Star Analytics experience
- You have strong analytical skills and are an expert in Excel and SQL
- You have strong verbal and written communication and 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 and conviction records. We are an E-Verify company.