Full-Time

Senior Manager

Actuarial Strategic Operations

Posted on 9/9/2026

Clover Health

Clover Health

501-1,000 employees

Medicare Advantage insurer with personalized care

Compensation Overview

$157.7k - $205k/yr

Remote in USA

Remote

Category
Business & Strategy (1)
Required Skills
Claude
Python
Data Visualization
R
Forecasting
SQL
Financial analysis
Data Analysis
Excel/Numbers/Sheets
Financial Modeling

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Requirements
  • Associate or Fellow of the Society of Actuaries and Member of the American Academy of Actuaries.
  • 7-10 years of progressive experience in actuarial, healthcare finance, population health, analytics, consulting, strategy, or operations, with demonstrated success leading cross-functional initiatives and driving organizational change.
  • Strong understanding of Medicare Advantage economics, including medical cost trends, utilization management, risk adjustment, provider reimbursement, or value-based care.
  • Advanced SQL and Excel skills.
  • Experience using Python or R, business intelligence platforms, and modern artificial intelligence tools such as ChatGPT, Claude, or Gemini to accelerate analysis, automate workflows, and enhance decision support.
  • Strong communication and executive presentation skills, with the ability to translate complex analyses into actionable business insights.
  • Experience leading and developing senior analysts or finance professionals, including setting priorities, allocating work, providing feedback and coaching, addressing performance concerns, and building team capability.
  • Ability to influence senior cross-functional stakeholders, build trusted business partnerships, navigate competing priorities, and drive sustained results in a highly matrixed organization.
Responsibilities
  • Set the direction and operating standards for Actuarial Strategic Operations, including governance, initiative portfolio management, prioritization, valuation, execution tracking, executive reporting, and continuous improvement of analytical and artificial-intelligence-enabled workflows.
  • Translate enterprise priorities into clear team goals, allocate resources based on business impact and capacity, and ensure the team delivers timely, high-quality decision support.
  • Lead the development and continuous evolution of enterprise performance monitoring frameworks using leading and lagging indicators, dashboards, and key performance indicators.
  • Establish analytical and quality standards, ensure consistent application across functional areas, and use performance trends to identify risks, prioritize team work, and guide leadership decisions.
  • Set standards for integrating operational, actuarial, and financial performance into clear recommendations for executive leadership.
  • Lead adoption of responsible artificial-intelligence-enabled analytical methods while maintaining appropriate governance, data integrity, and financial discipline.
  • Ensure analyses challenge strategic assumptions, surface material risks and opportunities, and provide actionable options supporting enterprise priorities and financial objectives.
  • Serve as the senior Command Center partner to leaders across Finance, Actuarial, Medical Economics, Clinical Operations, Revenue, Pharmacy, Product, and Analytics.
  • Establish ownership, decision rights, and accountability across initiatives; resolve competing priorities; and align work with budgeting, forecasting, strategic planning, and enterprise performance objectives.
  • Lead expansion of automation, process standardization, data-quality improvements, and artificial-intelligence-enabled solutions that improve reporting, accelerate analysis, reduce manual effort, and scale the Command Center operating model.
  • Ensure new tools and processes are adopted, governed, documented, and sustained across the team.
  • Lead, coach, and develop a team of financial operations and actuarial professionals responsible for complex modeling, analysis, business partnership, and executive decision support.
  • Set priorities and performance expectations, allocate work based on business impact and capacity, provide regular feedback and development opportunities, address performance concerns, and build team capabilities.
  • Build cross-functional partnerships with business leaders, establish the Command Center as a trusted strategic partner, and align objectives.
  • Establish the Command Center reporting framework, including key performance indicators, leading and lagging metrics, and a consistent reporting cadence across functional areas.
  • Develop executive dashboards and scorecards providing visibility into initiative performance, financial impact, and execution risks.
  • Assess team strengths, development needs, workload, and capacity, and establish clear roles, priorities, performance expectations, and operating rhythms.
  • Establish regular one-on-one meetings, team forums, quality reviews, and development plans supporting accountability and team growth.
  • Establish standards for financial analysis, modeling, executive reporting, and artificial-intelligence-enabled workflows.
  • Lead executive operating reviews by delivering data-driven insights on initiative performance, financial impact, emerging risks, and opportunities to senior leadership.
  • Implement a proactive risk-monitoring framework using leading indicators to identify execution gaps early and recommend mitigation strategies.
  • Provide actionable financial and operational insights supporting executive decision-making, enterprise prioritization, and business planning.
  • Establish performance management and development practices, including measurable goals, regular feedback, and defined growth opportunities.
  • Demonstrate effective delegation and capacity planning across a portfolio of enterprise priorities, adjusting resources as business needs evolve.
  • Influence enterprise prioritization through data-driven insights that inform strategic investment decisions and resource allocation across the Medicare Advantage business.
  • Continuously improve reporting processes, enhance data quality, and increase the efficiency and scalability of the Command Center operating model.
  • Establish the Command Center as the enterprise source of truth for initiative performance, execution monitoring, and financial insights supporting executive decision-making.
  • Develop a sustainable Command Center talent model with clear roles, succession coverage, and capabilities supporting Clover’s Medicare Advantage strategy.
  • Create a culture of ownership, analytical excellence, constructive challenge, and continuous improvement across the team.
  • Build team credibility with senior leaders by ensuring consistent quality, sound judgment, and measurable impact across enterprise decisions and initiatives.
Desired Qualifications
  • Experience applying artificial intelligence to improve analytical workflows, operational efficiency, or business decision-making.
  • Experience in managed care or healthcare actuarial functions.

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

  • Q2 2026 revenue hit $743.2 million, up 55.6%, with adjusted EBITDA $40.9 million.
  • Membership reached 157,309 in Q2 2026, driven by New Jersey and Georgia focus.
  • CMS’s June 17, 2026 recalculation preserved Clover’s 4.5 stars and lifted 2027 economics.

What critics are saying

  • CMS appealed on July 21, 2026, threatening Clover’s 4.5-star windfall before 2027 payments.
  • On July 4, 2026, attackers accessed three employee accounts handling PHI and PII.
  • If CMS overturns the 4.5-star ruling, Clover loses bonus payments and its MA model weakens.

What makes Clover Health unique

  • Clover Assistant links care decisions to claims data, supporting its AI-led Medicare Advantage model.
  • Judge Wood’s May 27, 2026 ruling restored Clover’s 4.5-star rating for 2027 payments.
  • Cash-rich, no-debt balance sheet gives management pricing and benefit flexibility.

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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

1%

1 year growth

0%

2 year growth

0%
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Aug 28th, 2026
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Germany's 10-year bond yield has reached levels not seen since 2011, signalling that markets expect interest rates to remain elevated for longer. Higher yields typically pressure richly valued large-cap stocks, shifting attention toward financially fit penny stocks with lower entry prices and stronger balance sheets. A screener identified 311 such companies. One example is TOYO Co., a solar manufacturer spanning the supply chain from silicon wafers to photovoltaic modules. With a market capitalisation of $199 million, TOYO reports approximately $549 million in revenue from machinery and industrial equipment. The company recently expanded in Houston and plans capacity growth in Ethiopia. New US master supply agreements and index inclusions indicate growing commercial traction. However, heavy reliance on external funding and rapid expansion introduce execution risks.

Impact Newswire
Aug 26th, 2026
A cyber attack has paralyzed Boston Scientific's global operations.

A cyber attack has paralyzed Boston Scientific's global operations. Boston Scientific says a cybersecurity incident has disrupted its global operations, including some information systems used to process and ship customer orders, making it the latest healthcare company to be hit by a cyberattack. The medical device maker said it detected the incident on Aug. 25 and immediately activated its incident-response procedures. The company is working with third-party cybersecurity specialists to investigate the attack and contain the threat. The incident is expected to continue affecting parts of Boston Scientific's business as the company works to restore its systems, it said. Boston Scientific said it had not determined whether the incident was reasonably likely to have a material impact on its business. The company said its investigation was ongoing and that the full scope and nature of the incident had not yet been determined. Shares of Boston Scientific fell 3.5% in premarket trading. Boston Scientific makes medical devices used in areas including cardiovascular, endoscopy, urology, neuromodulation and other medical specialties. The company operates globally, with manufacturing and distribution facilities across multiple regions. The disruption to systems used to process and ship customer orders could affect the company's ability to fulfill some orders while recovery efforts are underway, although Boston Scientific did not provide details on the extent of any delays. The attack adds to a growing list of cyber incidents affecting healthcare companies, which are frequent targets because of the sector's reliance on interconnected information systems and the sensitive nature of medical and patient data. Medical device makers Abbott Laboratories (ABT.N), Stryker (SYK.N) and Medtronic (MDT.N), health insurer Clover Health (CLOV.O), drugmaker Novo Nordisk (NOVOb.CO) and medical equipment supplier West Pharmaceutical Services (WST.N) have also recently reported cyber incidents. Healthcare companies have increasingly warned that cyberattacks can disrupt not only corporate IT systems but also manufacturing, supply chains, order processing and other business-critical operations. Boston Scientific did not disclose whether patient or other sensitive data had been accessed or compromised. The company also did not identify the perpetrators or provide details on the type of cyberattack involved. Stay ahead of the Stories shaping its world. Subscribe to Impact Newswire and join its WhatsApp Channel for updates on global tech, business, and innovation - all in one place. Dive deeper into the future with the Cause Effect 4.0 Podcast, where Impact Newswire explore the ideas, trends, and technologies driving the global AI conversation. Got a story to share? Contact Us to reach a global audience with Impact Newswire. Faustine Ngila is the AI Editor at Impact Newswire, based in Nairobi, Kenya. He is an award-winning journalist specializing in artificial intelligence, blockchain, and emerging technologies. He previously worked as a global technology reporter at Quartz in New York and Digital Frontier in London, where he covered innovation, startups, and the global digital economy. With years of experience reporting on cutting-edge technologies, Faustine focuses on AI developments, industry trends, and the impact of technology on society.

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.