Senior Actuarial Data Specialist

Clover is reinventing health insurance by working to keep people healthier.

We don't just provide health insurance—we deliver the kind of healthcare that people deserve. The Actuarial team at Clover is made up of collaborative and strategic thinkers who are excited about the impact that technology can have on healthcare. In this role, you will partner and help support a core area of responsibility for our Actuarial team.

As a senior actuarial data specialist, you will:

• Lead the design, development, implementation and maintenance of core data pipelines that support the needs of the actuarial function, including but not limited to valuation and reserve, MA pricing, trend development and forecasting, ACO performance, risk score performance, etc. 
• Ensure quality and timely delivery of data pipelines, eliminate redundancies, and capture missing data elements in order to enable periodic actuarial team deliverables as well as ad-hoc analyses.
• Coordinate solutions for data infrastructure needs and challenges between the actuarial and the Health Care IT teams, successfully communicating technology concepts to the actuarial team and actuarial / finance concepts to the technology team.
• Own the implementation and testing of transformations and other adjustments that are critical for the actuarial team’s work such as claims groupers, risk adjustment model outputs, MMR updates, clinical program engagement metrics, SNF data processing, etc. 
• Support the integration of new and existing data sources as Clover expands into new markets and new business lines, while leveraging current data infrastructure features.
• Coordinate data requirements within the actuarial team to ensure that resources are employed consistently and efficiently, while enabling single source of truth, issue resolution and prioritization of process enhancements.
• Support compliance under Sarbanes Oxley, including through process documentation, peer review and control testing.

You will love this job if:

• You are passionate about your career in data engineering / management and want to be a part of an actuarial team providing value in a highly collaborative and cross-functional environment.
• You dream about ways to make the healthcare system more efficient and are excited about the prospect of leveraging modern tools and  techniques to do so.
• You are analytical and strategic and love working in a collaborative, transparent work environment.
• You want to make an impact. From project scope to priority to implementation, you'll have an impact on how decisions get made.

You should get in touch if:

• You have 6 years or more of working with actuaries and their data needs, including support for claims-focused ETLs, pipeline design, and data manipulation.
• You have a passion for building automated data pipelines and tools that will enable actuarial analyses of complex business problems.
• You have strong data manipulation skills. 
• You have strong problem solving skills with a focus on leveraging technology and data to solve business problems, addressing problems both conceptually and practically.
• You have expert level programming skills, including in SQL, R, Python, SAS and other coding platforms, with an understanding of how to structure deployment to ensure high quality.
• Experienced with Medicare Advantage plan and/or CMS CCLF claims structure. 
• Experienced with the CMS-HCC risk adjustment model is a plus.

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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.

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 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.