
Data Analyst, Value-Based Care Analytics
Clover Health
Posted about 4 hours ago
Counterpart Health is an AI‑powered physician enablement platform that delivers clinical insights to providers at the point of care. Our flagship product, Counterpart Assistant, is embedded into clinicians’ workflows and integrates with EHR systems, helping care teams drive value-based outcomes, close care gaps, and proactively manage chronic disease. As we expand across Medicare Advantage and other value-based care programs, we need analytical talent that can translate complex clinical and financial data into narratives that drive action, for both our internal teams and our payer and provider customers.
You will be part of the analytical engine behind Counterpart Health’s value-based care performance insights. This role sits at the intersection of risk adjustment, quality measurement, utilization management, and cost analytics, and you will be expected to own the metrics that matter most to our payer and provider partners. Beyond the numbers, you are a storyteller: you turn dense claims and clinical data into clear, compelling narratives that help customers understand performance, identify opportunities, and take action. You will work closely with Customer Success, Clinical, and Product teams to ensure our analytics are accurate, trusted, and decision-ready.
As a Data Analyst, you will:
- Build and maintain core Value-Based Care (VBC) performance metrics across risk, quality, utilization, and cost domains, including HCC capture rates, RAF scores, PMPM trends, and inpatient/ED utilization rates.
- Develop customer-facing analytics, reports, and dashboards that surface actionable performance insights for payer and provider partners in a clear, narrative-driven format.
- Analyze Medicare Advantage performance data, including risk adjustment, quality bonus payments, and benchmark performance, to identify gaps, trends, and opportunities at the patient, provider, and market level.
- Translate complex data findings into executive-ready narratives: written summaries, slide-ready visuals, and structured QBR materials that tell a coherent story about performance and next steps.
- Conduct deep-dive utilization and cost analyses, including high-cost claimant reviews, avoidable utilization patterns, and specialty/pharmacy spend trends, to identify levers for improvement.
- Partner with Customer Success and Provider Operations teams to prepare and deliver performance reviews (QBRs, monthly reporting packages) that communicate value and surface priority action areas for each customer.
- Collaborate with Data Engineering to validate claims and clinical data pipelines, flag anomalies, and ensure metric consistency across customer populations.
- Contribute to the development of scalable analytics infrastructure: reusable SQL libraries, metric definitions, and documentation that enable the team to move faster.
You should get in touch if you have:
- 4+ years of hands-on healthcare data analytics experience, with direct exposure to payer or provider customers in a value-based care context.
- Deep familiarity with VBC metrics: risk adjustment (HCC coding, RAF scores), utilization (IP admissions, ED visits, readmissions), and cost (PMPM, total cost of care, benchmark vs. actual).
- Strong SQL skills, able to write complex queries across claims, eligibility, and clinical datasets in cloud-based warehouses (BigQuery, Snowflake, or similar).
- Exceptional data storytelling ability: you can translate analytical findings into clear narratives and visuals that resonate with both clinical and non-technical audiences.
- Experience building customer-facing reports and dashboards; comfortable presenting findings to external stakeholders (health plans, provider groups, ACOs).
Preferred Qualifications:
- Medicare Advantage experience, including familiarity with CMS risk adjustment models (CMS-HCC v24/v28), Star Ratings methodology, and MA quality bonus payment structures.
- Familiarity with clinical terminologies: ICD-10, CPT/HCPCS, NDC, SNOMED, LOINC.
- Experience using Python or R for data manipulation, cohort analysis, or statistical modeling.
- Background working with EHR or clinical data alongside claims (e.g., for care gap closure, chronic condition identification, or attribution logic).
- Prior experience in a health plan, risk-bearing provider group, ACO, or health tech company supporting VBC programs.
Benefits Overview:
- 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.
Additional Perks:
- 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!
About Counterpart Health: In 2018, Clover Health set out to do something unprecedented: build a clinically intuitive, AI-enabled solution that fits within physicians' workflows to help support the earlier diagnosis and management of chronic conditions.
Years later, that vision is a reality, with thousands of practitioners using Counterpart Assistant during patient visits to improve disease management, reduce medical expenses, and drive success in value-based care.
With an exceptional team of value-based care and technology experts, Counterpart Health is driving value-based care at the speed of software.
Counterpart Health is a subsidiary of Clover Health. 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, perspectives, opinions, 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.
#LI-REMOTE
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.
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