Clinical Support Analyst - Work at Home

CVS Health•Work At Home-Florida, FL

6d•$43,888 - $85,068•Remote

About The Position

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary The LTSS Operations Analyst supports LTSS leadership by managing operational reporting, monitoring case management assignments and caseloads, supporting timely State reporting, and providing data-driven insight to improve performance, compliance, and member outcomes. This role helps ensure work is completed accurately, timely, and in alignment with contractual and regulatory requirements.

Requirements

Bachelor's degree in Healthcare Administration, Business Administration, Public Health, Data Analytics, or related field preferred.
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.

Nice To Haves

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.

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.