Note: The job is a remote job and is open to candidates in USA. CVS Health is focused on creating a more connected, convenient, and compassionate health experience. The Clinical Support Analyst supports LTSS leadership through operational reporting, case management assignment and caseload monitoring, State reporting, data analysis, compliance support, and process improvement initiatives.
Responsibilities
- Manage case management assignments from initial outreach through reassignment and monthly caseload rebalancing
- Monitor caseload distribution to support staffing alignment, workload balance, and contractual requirements
- Track assignment changes and ensure operational data remains accurate and current
- Prepare and support timely State-required reports with accurate, detailed information prior to submission
- Track performance against contractual, regulatory, and organizational requirements
- Validate data for accuracy, completeness, and reporting integrity
- Develop and maintain reports, dashboards, scorecards, and tracking tools
- Monitor KPIs, identify trends, and provide leadership with actionable insights
- Analyze staffing, productivity, workload distribution, utilization activity, and provider-related impacts
- Partner with LTSS leaders to identify process gaps, risks, and improvement opportunities
- Prepare executive summaries, presentations, and business review materials
- Support audits, accreditation activities, special projects, and regulatory readiness efforts
- Collaborate with Case Management, Quality, Network, Compliance, Finance, and Provider Relations
- Communicate findings clearly and concisely to support timely operational action
Skills
- 2+ years of healthcare, managed care, business analytics, or operational analysis experience
- Advanced proficiency in Microsoft Excel, required
- Strong analytical, organizational, and problem-solving skills
- Excellent written and verbal communication skills, required
- Bachelor's degree in Healthcare Administration, Business Administration, Public Health, Data Analytics, or related field preferred
- Experience with Power BI, Tableau, QuickBase, SQL, or similar reporting tools preferred
- Medicaid managed care experience
- LTSS, case management, utilization management, or provider operations experience
- Experience supporting executive reporting and performance improvement initiatives
- Knowledge of healthcare quality metrics and regulatory requirements
Benefits
- CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above
- Work at home
- Medical coverage, based on eligibility
- Dental coverage, based on eligibility
- Vision coverage, based on eligibility
- Paid time off, based on eligibility
- Retirement savings options, based on eligibility
- Wellness programs, based on eligibility
- Other resources supporting the physical, emotional, and financial well-being of colleagues and their families, based on eligibility
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