Full-Time

Data Analyst

Clinical Data Effectiveness

Clover Health

Clover Health

501-1,000 employees

Medicare Advantage insurer with personalized care

No salary listed

Remote in USA

Remote

Category
Data & Analytics (1)
Required Skills
Python
SQL

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Requirements
  • 2+ years of hands-on data analytics experience, with direct exposure to healthcare data interoperability
  • Strong hands-on experience with healthcare data standards: HL7, CCDA, and ADT messages.
  • Proficiency in SQL and comfort working with large, complex datasets (claims, clinical logs, interoperability data).
  • Background in analyzing interoperability networks (e.g., Carequality, CommonWell, eHealthExchange) or HIE integrations.
  • Skilled at data visualization and able to present complex findings to both technical and non-technical stakeholders.
  • Strong investigative mindset, i.e., you enjoy digging into the “why” behind missing data and diverging metrics.
  • Self-directed and able to manage multiple analytical projects (vendor comparisons, visit-level reconciliation) without constant supervision.
Responsibilities
  • Proactively identify and monitor which healthcare facilities consistently generate high-quality, usable clinical documents (e.g., EHRs, discharge summaries, procedure notes) to precisely locate and quantify data gaps.
  • Conduct deep-dive analyses by mapping and correlating facility-specific data across disparate sources like structured claims, clinical care summaries (CCDAs), and ADT messages to uncover systematic patterns of missingness, latency, or incongruence in clinical records.
  • Experience with TEFCA/QHIN frameworks and evolving national interoperability standards.
  • Familiarity with vendor-specific data exchange platforms (e.g., Bamboo Health, HSX, Particle Health, Kno2).
  • Background in value-based care, population health, or clinical data operations.
  • Experience with claims-clinical data reconciliation (e.g., matching EOBs to clinical encounter records).
  • Comfort working with Python or similar tools for data manipulation and automation.
  • Establish and maintain clear, transparent reporting on ADT coverage across key geographic, organizational, and technological dimensions (e.g., by county, facility, and underlying EMR system).
  • Based on rigorous analysis of data flow and quality, recommend and guide the implementation of optimal technical configurations for existing data vendors (e.g., Bamboo Health, PCC, Experian, HSX).
  • Conduct comprehensive evaluations and proof-of-concepts for potential new data integration technologies (e.g., Kno2 vs. Particle Health) to assess viability, quality improvements, and strategic fit.
  • Systematically determine the existence and completeness of documentation associated with specific patient visits or encounters.
  • Develop a data-driven framework for prioritizing facility targets for direct data acquisition, assessing impact, cost-effectiveness, and technical feasibility.
  • Inform and guide vendor strategy around national initiatives such as TEFCA and QHIN adoption, ensuring Counterpart Health is positioned for compliant, high-quality data exchange.
  • Partner cross-functionally with Product Managers to define data requirements, Engineers to implement reliable pipelines, and Clinical teams to validate data quality and clinical utility.
  • Act as a critical liaison to identify and remove operational and technical bottlenecks, ensuring a predictable, scalable, and reliable clinical data flow across all customer markets.
Desired Qualifications
  • Experience with TEFCA/QHIN frameworks and evolving national interoperability standards.
  • Familiarity with vendor-specific data exchange platforms (e.g., Bamboo Health, HSX, Particle Health, Kno2).
  • Background in value-based care, population health, or clinical data operations.
  • Experience with claims-clinical data reconciliation (e.g., matching EOBs to clinical encounter records).
  • Comfort working with Python or similar tools for data manipulation and automation.

Clover Health provides Medicare Advantage plans for seniors in the United States, offering coverage that goes beyond traditional Medicare. Its services include personalized care, fitness memberships, home checkups, drug coverage, and Medigap insurance, with revenue coming from member premiums and Medicare reimbursements. The product works by enrolling members in Medicare Advantage and delivering added benefits through a network of healthcare providers and fitness centers, plus home visits and proactive support to manage health. The company differentiates itself with a focus on tailored, attentive care and a growing provider network to enhance member benefits, aiming to improve health outcomes. Its primary goal is to help seniors stay healthier and reduce out-of-pocket costs by combining comprehensive coverage with personalized services.

Company Size

501-1,000

Company Stage

IPO

Headquarters

Nashville, Tennessee

Founded

2014

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Simplify Jobs

Simplify's Take

What believers are saying

  • August 5, 2026 guidance rose to $2.92 billion-$3.0 billion revenue and $70-$85 million EBITDA.
  • Q2 2026 membership reached 157,309, up 48%, extending scale across core states.
  • A 4.5-star 2027 payment-year rating supports richer reimbursement and stronger retention.

What critics are saying

  • CMS appealed the July 2026 star-rating ruling; 2027 bonus payments now face reversal.
  • The July 4, 2026 breach exposed member PHI, triggering OCR, lawsuits, and monitoring costs.
  • Q4 2026 seasonal losses and an 86.5% claims ratio keep execution fragile.

What makes Clover Health unique

  • Clover Assistant turns claims data into physician prompts across Medicare Advantage visits.
  • Full-risk Medicare Advantage plus wide-network focus in New Jersey and Georgia differentiates Clover.
  • AI underwriting and home-visit operations combine clinical control with insurance economics.

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Benefits

Health Insurance

Dental Insurance

Vision Insurance

401(k) Company Match

Performance Bonus

Unlimited Paid Time Off

Remote Work Options

Parental Leave

Professional Development Budget

Phone/Internet Stipend

Growth & Insights and Company News

Headcount

6 month growth

0%

1 year growth

0%

2 year growth

-1%
Yahoo Finance
Aug 20th, 2026
Clover Health beats Q2 revenue estimates with 55.6% growth to $743M

Clover Health reported Q2 revenues of $743.2 million, up 55.6% year-on-year and exceeding analyst expectations by 2%. The Medicare Advantage provider also beat EPS estimates and issued full-year EBITDA guidance above analyst expectations. "Our results demonstrate that a wide-network, full-risk Medicare Advantage model can deliver better health outcomes, meaningful growth, and increasing profitability at the same time," said CEO Andrew Toy. The company's shares rose 1.9% following the results and currently trade at $4.22. This performance stood out amongst the 12 health insurance providers tracked, which collectively saw share prices fall 6.2% since their latest earnings despite revenues beating consensus estimates by 2.8%.

Yahoo Finance
Aug 14th, 2026
Clover Health beats Q2 estimates with $743M revenue, raises full-year guidance as AI platform drives growth

Clover Health reported second-quarter results that exceeded analyst expectations, with revenue of $743.2 million beating estimates by 2% and adjusted EBITDA of $40.92 million surpassing forecasts by 34.7%. The Medicare Advantage insurer's membership grew to 157,309, up from 155,773 in the previous quarter. CEO Andrew Toy attributed the performance to the company's Clover Assistant AI platform and disciplined market focus in New Jersey and Georgia. He emphasised that "better clinical care leads to stronger cohort economics." The company raised its full-year revenue guidance to $2.96 billion from $2.87 billion, a 3.3% increase. EBITDA guidance of $77.5 million exceeded analyst estimates of $58.44 million. Operating margin improved to 3.8%, up from negative 2.2% in the same quarter last year. Management credited favourable medical cost trends and improved operating leverage.

Yahoo Finance
Aug 13th, 2026
Clover Health grows MA membership 48% while boosting net income $67M in first half of 2026

Clover Health reported strong performance in the first half of 2026, with Medicare Advantage membership growing 48% and GAAP net income increasing by $67 million year-over-year. Chief executive officer Andrew Toy highlighted the company's focus on using AI to improve physician decision-making through its Clover Assistant platform. The earnings call, held on 5 August 2026, emphasised how technology-driven improvements in patient care can drive both membership growth and profitability simultaneously. Toy stated that Clover's approach centres on helping physicians make better decisions for individual patients, rather than simply making the healthcare system marginally more efficient. The results demonstrate the company's progress in scaling its AI-assisted healthcare model across its Medicare Advantage business.

Yahoo Finance
Aug 6th, 2026
Clover Health raises 2026 outlook as Medicare membership surges 48% to 157K

Clover Health reported strong second-quarter results, with Medicare Advantage membership rising 48% year-over-year to 157,000 and revenue growing 56% to $743 million. The company generated $41 million in adjusted EBITDA and $28 million in GAAP net income, ending the quarter with $443 million in cash and no debt. The health insurer raised its full-year 2026 outlook for membership, revenue, gross profit, adjusted EBITDA and GAAP net income. Management expects positive adjusted EBITDA in the third quarter but anticipates a seasonal loss in Q4. Consolidated gross profit reached $153 million, up 54% from last year. All members are now enrolled in plans rated 4.5 stars for the 2027 payment year, though the Centers for Medicare & Medicaid Services plans to appeal the related court decision.

Yahoo Finance
Aug 5th, 2026
Clover Health revenue jumps 55.6% to $743M, beats Q2 estimates and raises full-year guidance

Clover Health reported second-quarter revenue of $743.2 million, beating analyst estimates of $728.2 million and marking 55.6% year-on-year growth. The health insurance company's shares rose 10.3% following the announcement. The company posted GAAP earnings of $0.05 per share, surpassing consensus estimates of $0.03. Adjusted EBITDA reached $40.92 million, exceeding expectations of $30.38 million by 34.7%. Clover Health raised its full-year revenue guidance to $2.96 billion at the midpoint, up from $2.87 billion previously. Full-year EBITDA guidance of $77.5 million also came in above analyst estimates of $58.44 million. The company's customer base grew to 157,309, up from 155,773 in the previous quarter. Operating margin improved to 3.8%, compared with negative 2.2% in the same period last year.