Senior Analyst, Medicare Stars (Pharmacy Programs)

Clover Health

3h•Remote

About The Position

Our Part D organization is responsible for creating the most comprehensive and affordable drug plan for Clover Health’s Medicare members. The analytics team is critical within this org. to identify, diagnose and measure how support for members can be improved. We're looking for a Senior Analyst to own end-to-end analytics for Medicare Part D Stars performance and pharmacy programs. You'll sit at the intersection of data, clinical strategy, and operations — ensuring that insights aren't just accurate and scalable, but actionable and embedded in the workflows that drive real health outcomes.

Requirements

4–6+ years of experience in healthcare analytics, with direct exposure to Medicare Advantage Part D measures, PQA specifications, and pharmacy data.
Proficient in SQL and experienced building, validating, and QA-ing complex datasets across claims, pharmacy, eligibility, and vendor sources.
Familiar with CMS Stars, HEDIS, CAHPS, and regulatory requirements, and can work within BI tools like Tableau, Looker, Power BI, or Mode.
Communicate clearly across technical and non-technical audiences and can translate complex data into actionable insights for stakeholders at all levels.

Nice To Haves

You've evaluated programs, interventions, or vendor performance using structured measurement frameworks — and can connect the findings back to business decisions.

Responsibilities

Own Part D Stars analytics end-to-end. Serve as the single-threaded owner for Stars performance, tracking KPIs and ROI across pharmacy programs — ensuring outputs directly inform interventions and business decisions.
Build and maintain data infrastructure. Design, optimize, and QA SQL-based pipelines and datasets across claims, pharmacy, and vendor sources. Partner with Data Engineering on architecture, automation, and documentation aligned to CMS (Centers for Medicare and Medicaid Services), PQA (Pharmacy Quality Alliance), and internal standards.
Generate and communicate insights. Analyze Part D Stars measures to identify trends, gaps, and early warning signals. Translate findings into clear recommendations and build dashboards that support both operational and executive decision-making.
Evaluate programs and vendors. Design test-and-learn frameworks to assess the effectiveness of Stars campaigns, pharmacy interventions, and vendor programs. Define success metrics, run cohort analyses, and apply learnings to future improvements.
Enable cross-functional partners. Act as the primary analytics partner for Pharmacy Stars Operations and vendor teams. Bridge business needs to technical teams, and partner with Product and Engineering to integrate insights into Counterpart Assistant and provider workflows.
Build operational structure. Establish standardized analytics workflows, SOPs, and intake processes. Drive consistent use of measure logic and business rules across teams to support a scalable performance management cadence.