Maintain internal CMS HCC and RxHCC models for calculating member level risk scores.
Support the monthly close process, including the development of actuarial risk adjusted revenue accruals and analysis of results.
Build reports to track ROI on various risk adjustment initiatives.
Support actuarial teams in the development of risk scores for forecast and bidding purposes.
Provide actuarial support on a wide variety of topics including risk adjustment, pricing, forecasting, reserving, trend analysis, and value-based care.
Communicate analysis, findings, and supporting data meaningfully to leadership and partnering teams.
Build automated actuarial tools and data pipelines.
Support compliance under Sarbanes Oxley, including through process and tool design, peer review and control testing.
Be accountable for key work products under the supervision of experienced actuaries.
Collaborate with internal departments, including but not limited to, Data Science, Finance, Actuarial, Operations, Provider Network Management, Engineering, and external vendors on risk adjustment activities.
Be eligible to participate in Clover's Actuarial Student Program.

You have at least one year experience in health insurance; Medicare experience is preferred.
You have completed at least two actuarial exams.
You have an interest in building automated tools around actuarial analysis and experience building analytic dashboards.
You have basic programming skills, such as SQL, SAS, R, or Python.
You are a self-starter, have a high degree of internal drive and motivation, and desire to execute at a high level.
You have two years experience with Medicare Risk Adjustment, CMS EDS submissions, and healthcare claims data.
You have at least two years of programming experience. Examples include SQL, R, Python, SAS, VBA.
You have an interest in building automated tools around actuarial analysis and experience building analytic dashboards.
You are a self-starter, have a high degree of internal drive and motivation, and desire to execute at a high level.

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.
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!

Senior Actuarial Analyst

Key skills