Be responsible for the monitoring and management of the end to end data flow of data submissions to vendors and government agencies to mitigate data leakage and submission errors.
Own the claim and supplemental submission workflow for CMS EDS submissions.
Develop data pipeline tracking reports and analyze, research, and resolve encounter data errors.
Support the claim and supplemental submission workflow for CMS EDS submissions.
Collaborate closely between the Engineering and Risk Adjustment teams.
Assist with, track, and implement risk adjustment related initiatives and strategies.
Maintain, update, and create policies, procedures, and other documentation around the encounter process.

Requirements

You have two years experience with Medicare Risk Adjustment, CMS EDS submissions, and healthcare claims data.
You have at least two years of programmers experience using SQL, Python, and R.
You have experience with building operational level dashboards.
You are a self-starter, have a high degree of internal drive and motivation, and desire to execute at a high level.
You are relentlessly focused on serving the needs of diverse business customers.

Benefits

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!

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills & Tools

SQLPythonRdata pipeline trackingoperational dashboardsdata analysisdata managementdata submissiondata error resolutionrisk adjustment

Soft Skills

self-starterinternal drivemotivationhigh execution levelcustomer service focus