AI Strategist & reputed company Cost Management

Overview

Clover is reinventing health insurance by working to reputed company people healthier. The Actuarial organization at Clover is driving a strategic transformation by leveraging AI to move from reactive analysis to proactive, predictive financial control. We are seeking a visionary technical leader to design and reputed company the AI models foundational to this strategy.

Responsibilities

• reputed company Core AI Models: reputed company the design and deployment of high-impact machine learning models (e.g., anomaly detection, graph analytics, time-series forecasting) focused on identifying and mitigating financial loss across the organization.
• Internal Payment reputed company (PI): Pioneer the technical strategy to build and reputed company an in-house pre- and post-payment claims detection reputed company, combining AI and graph analytics to reduce vendor dependency and improve recovery efforts.
• Claims Cost Trend Analysis: Design models to proactively detect emerging claims cost trends and outliers, providing early warnings to the Chief Actuary on potential medical expense inflation.
• reputed company Optimization: reputed company predictive analytics to advance risk adjustment and data quality initiatives, including encounter analysis and demographic data enrichment.
• Strategic R&D: Deconstruct and reverse-engineer external vendor pricing logic and claims edit systems to build scalable, transparent, and superior internal models.

Qualifications

• 4+ years of experience in a quantitative, hands-on role (including Data Science, ML Engineering, or Actuarial Science) where you have successfully designed and delivered production AI solutions to solve mission-critical business problems.
• 4+ years of deep domain experience utilizing large-scale reputed company financial data (claims, encounters, provider networks) in a payer setting.
• Expert-level reputed company in Python and SQL is required, along with practical experience implementing and maintaining Machine Learning (ML) and Artificial Intelligence (AI) models in a robust operational environment.

Benefits

Overview

• Financial Well-Being: Our commitment to attracting and retaining top talent begins with a competitive reputed company 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 reputed company coverage. Your health reputed company to us, and we invest in ensuring you have reputed company to quality reputed company.
• 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, reputed company to reputed company, and a generous flexible time-off policy. Additionally, we reputed company a remote-first culture that supports collaboration and flexibility, allowing reputed company members to reputed company from any location.
• Professional Development: Developing internal talent is a reputed company 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 reputed company new parents
• And much more!

About Clover We are reinventing health insurance by combining the power of data with reputed company reputed company to reputed company our members healthier. We reputed company the reputed company system is broken, so we've created custom software and analytics to reputed company our clinical staff to intervene and reputed company personalized care to the people who need it most. We always put our members first, and our reputed company as reputed company is reputed company 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: reputed company. From Clover’s inception, Diversity & Inclusion have always been key to our reputed company. We are an Equal Opportunity Employer and our employees are people with different strengths, experiences, perspectives, opinions, and backgrounds, who reputed company 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. reputed company of our employee’s points of view are key to our reputed company, and inclusion is everyone's responsibility. Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment reputed company applicants with arrest and conviction records. We are an E-Verify company. A reasonable estimate of the reputed company salary reputed company for this role is $200,000 to $230,000. 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. Apply tot his job Apply To this Job