Financial Operations Analyst, Clover Health
+ ESPP
Medicare provider
Posted today
Medicare provider
501-1000 employees
Posted today
+ ESPP
501-1000 employees
Company mission
To improve the quality of life of our members and physicians by reducing doctor-insurer friction and increasing visibility into the health of each patient, leading to improved care.
Role
Who you are
- You are proficient in financial modeling, data visualization, and reporting tools, including advanced Excel, SQL, and data analytics platforms (e.g., Tableau, Power BI, Mode Analytics, R)
- You have a Bachelor's degree in Finance, Accounting, Data Science, Healthcare Administration, or a related field
- You have extensive experience in financial analysis, preferably in the healthcare or insurance industry, with a strong background in data analytics
- You have advanced analytical and problem-solving skills, with expertise in data manipulation and interpretation
- You have excellent communication and interpersonal skills, with the ability to present complex data findings to diverse audiences
What the job involves
- This Role will be focused on Clinical Programs owned by Clover Health’s Chief Medical Officer such as Utilization Management, Pharmacy Benefit Management and Medicare Star Rating Support
- As a Financial Operations Analyst, this role will act as a liaison between the Finance Team and the Clinical Team - both measuring past performance outcomes to the Clinical Business Owners and relaying expected changes to the Financial Forecasting Team
- Use SQL and other data analysis tools to monitor, refine and combine multiple data models centered around Medical Prior Authorizations, Step Therapy reviews and Pharmacy/Medical Claims
- Develop and maintain complex financial models to project the costs and savings associated with various clinical programs and interventions
- Prepare detailed reports and presentations for management, highlighting financial performance, clinical program outcomes, and key metrics related to data analysis
- Support the budgeting and forecasting processes for Medicare Advantage, integrating data-driven insights from clinical program performance to inform financial projections
- Collaborate with cross-functional teams, including actuarial, claims, clinical, and data science, to address financial issues, support strategic initiatives, and evaluate clinical outcomes
- Develop and maintain documentation for financial processes and procedures, including detailed protocols for data analysis and clinical program evaluation
- Provide data-driven analyses on current and prospective vendor return on investment scores
- Success in this role looks like:
- Becoming subject matter expert in all clinical program data models
- Collaborating with clinical process owners to develop insightful reports used in business decision making
- Alerting actuarial forecasters of clinical process changes and the expected financial impact
- Demonstrating financial impact of clinical programs to process owners and executive leadership
Our take
Clover Health is a medical insurance company operating as a Preferred Provider Orgaization for Medicare Advantage, the Medicare plan for elderly American citizens. It aims to reduce the doctor-insurer friction to increase visibility into the health of patients.
Through its approach, Clover's physicians are able to focus on people, rather than paperwork. It has a patient-centered analytics and dedicated care management team, and thus is able to rapidly identify potential healthcare risks to provide preventative care. This helps to provide a more sophisticated level of care than existing providers, even if its market share is relatively slim compared to competitors like UnitedHealthcare and Humana.
Over the years it has performed well in a rapidly growing market, but in 2021 ran into issues with profitability in the market due to inefficient costings, an issue it is steadily nipping in the bud in 2023. However, the number of elderly Americans has doubled over the past 25 years, and the market is expected to do the same between now and 2025. This upward trend brings hope of revitalising the growth and strong financial performance Clover has seen in recent years, especially as it focuses more on profitability through 2023.
Kirsty
Company Specialist at Welcome to the Jungle
Insights
-4% employee growth in 12 months
Company
Funding (last 2 of 5 rounds)
Jan 2019
$500m
SERIES E
May 2017
$130m
SERIES D
Total funding: $925m
Company benefits
- Paid parental leave and a life insurance policy
- Commuter benefit program
- 2 paid volunteer days for an organization of your choice
- 401(k) contributions
- Home office reimbursement for full-time employees
- 18 paid vacation days, 9 paid sick days, 10 company holidays, and a floating holiday
- Medical, dental, and vision plans; healthcare and dependent care FSA as well as a health and wellness benefit
Company HQ
Downtown, Nashville, TN
Leadership
Vivek Garipalli
(CEO & Board Member)They started out in Healthcare Investment Banking with Credit Suisse before joining the Blackstone Group. They also worked in Private Equity at J.P. Morgan, and co-founded Ensemble Health Partners and CarePoint Health System.
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