Job Overview
Location
Remote - USA
Job Type
Full-time
Category
Data Science
Date Posted
April 21, 2026
Full Job Description
đź“‹ Description
- • Act as a strategic technical leader bridging actuarial, payment integrity, product, finance, and medical economics teams to optimize enterprise financial performance through AI/ML innovation.
- • Lead the design and deployment of high-impact AI/ML models to identify financial risks and opportunities across payer operations, including payment integrity, revenue integrity, and medical cost analysis.
- • Serve as a hands-on technical engine who translates ambiguous business questions into production-ready analytical solutions grounded in healthcare economics and government programs.
- • Partner with cross-functional teams to enhance fraud, waste, and abuse detection, improve revenue accuracy, and build analytical frameworks for precise financial forecasting and intervention.
- • Operate in a remote-first, mission-driven culture focused on reinventing health insurance through data, AI, and empathy to improve member health outcomes.
🎯 Requirements
- • 5+ years of experience in a highly quantitative, hands-on role (Actuarial Science, Healthcare Data Science, or ML Engineering) with a track record of shipping production-grade analytical or AI solutions.
- • Direct experience or exposure to health insurance economics, claims, and risk adjustment within Medicare Advantage, Medicaid, or ACA/Marketplace environments.
- • Experience with LLMs or Generative AI in healthcare or insurance workflows, particularly where explainability, auditability, and operational adoption are critical.
- • High proficiency in Python and SQL, with practical experience developing, deploying, and maintaining AI models in an operational environment.
- • Strong business intuition to connect data anomalies to underlying financial or actuarial impact without requiring translation.
🏖️ Benefits
- • Competitive base salary ($165,000–$220,000 USD), equity opportunities, performance-based bonus program, and 401k matching.
- • Comprehensive medical, dental, and vision coverage, plus mental health resources, No-Meeting Fridays, monthly company holidays, and generous flexible time-off policy.
- • Professional development funding, mentorship, learning programs, and regular performance feedback and reviews.
- • Employee Stock Purchase Plan (ESPP), office setup reimbursement, monthly cell phone and internet stipend, and paid parental leave for all new parents.
- • Remote-first culture enabling collaboration from any location, with a focus on work-life balance and inclusion.
Skills & Technologies
About Clover Health Investments, Corp.
Clover Health Investments, Corp. is a healthcare technology company focused on improving the health and well-being of its members. The company aims to make healthcare affordable and accessible for everyone, particularly seniors and those in underserved communities. Clover Health integrates insurance and healthcare services, offering a range of Medicare Advantage plans. Their approach emphasizes proactive care, leveraging data analytics and a dedicated care team to help members navigate the healthcare system, manage chronic conditions, and achieve better health outcomes. They strive to simplify the healthcare experience through technology and personalized support, making quality care more attainable and understandable for their members.
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