We dont 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 technology can have on healthcare. We sit at the intersection of data, finance, and clinical strategy, translating complex insights into decisions that directly improve member outcomes and company performance.
In this role, you will partner and help support a core area of responsibility for our Actuarial team, contributing to high-visibility work that informs revenue, pricing, and long-term growth strategy. Were looking for a tech-savvy actuarial analyst interested in enhancing Clover's ability to make smart, data-driven business decisions to join our team. You will work with large, complex healthcare datasets and leverage automation to improve accuracy, efficiency, and transparency across actuarial processes. This is an opportunity for someone who enjoys solving ambiguous problems, building scalable tools, and seeing their work directly influence financial and operational strategy.
Senior Actuarial Analyst
As a Senior Actuarial Analyst, you will:
• 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.
Success in this Role
Within the first 90 days, you will learn Clover's CMS HCC/RxHCC models and accurately support monthly close and revenue accrual processes, deliver clear and reliable analyses using claims and EDS data, and identify opportunities to improve or automate actuarial workflows.
Within the first 6 months, you will independently own components of risk score modeling, forecasting, and monthly close processes, build automated tools or dashboards that improve efficiency and insight, and provide actionable analysis to support bidding and risk adjustment strategy.
Future success looks like driving accurate revenue projections, serving as a trusted Medicare Risk Adjustment partner, continuously enhancing automation and financial controls, and contributing strategic insights that support value-based care and long-term growth.
Requirements
You should get in touch if:
• You have at least one year of 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 of experience with Medicare Risk Adjustment, CMS EDS submissions, and healthcare claims data. • You have at least two years of programming experience.
Benefits Overview
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.
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.
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.
Developing internal talent is a priority for Clover. We offer learning programs, mentorship, professional development funding, and regular performance feedback and reviews.
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, 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.
Company Culture
We are an E-Verify company. A reasonable estimate of the base salary range for this role is $108,000 to $132,000. Final pay is based on several factors including but not limited to internal equity, market data, and the applicant's education, work experience, certifications, etc.
Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.