Clinical Support Analyst

This is a fully remote position, open to applicants in Florida.

📋 Description

• Oversee case management tasks from initial outreach to reassignment and monthly caseload adjustments.

• Supervise caseload allocation to ensure alignment with staffing, workload balance, and contractual obligations.

• Monitor assignment modifications and keep operational data accurate and up-to-date.

• Prepare and facilitate timely reports mandated by the State.

• Assess performance in relation to contractual, regulatory, and organizational standards.

• Ensure data accuracy, completeness, and integrity in reporting.

• Create and sustain reports, dashboards, scorecards, and tracking tools.

• Track key performance indicators (KPIs), pinpoint trends, and offer actionable insights to leadership.

• Evaluate staffing, productivity, workload distribution, utilization activities, and impacts related to providers.

• Collaborate with LTSS leaders to identify gaps in processes, risks, and areas for improvement.

• Prepare executive summaries, presentations, and materials for business reviews.

• Assist with audits, accreditation processes, special projects, and efforts related to regulatory readiness.

• Work in partnership with Case Management, Quality, Network, Compliance, Finance, and Provider Relations.

• Clearly and concisely communicate findings to facilitate timely operational responses.

⛳️ Requirements

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

• Minimum of 2 years of experience in healthcare, managed care, business analytics, or operational analysis.

• Required advanced proficiency in Microsoft Excel.

• Preferred experience with Power BI, Tableau, QuickBase, SQL, or equivalent reporting tools.

• Strong skills in analysis, organization, and problem-solving.

• Excellent written and verbal communication skills are required.

• Medicaid managed care experience is preferred.

• Preferred experience in LTSS, case management, utilization management, or provider operations.

• Experience in supporting executive reporting and performance improvement initiatives is preferred.

• Knowledge of healthcare quality metrics and regulatory requirements is preferred.

• Must be available to work in Eastern Standard Time (EST).

🏝️ Benefits

• CVS Health bonus, commission, or short-term incentive program in addition to the base pay range.

• Medical coverage.

• Dental coverage.

• Vision coverage.

• Paid time off.

• Retirement savings options.

• Wellness programs.

• Additional resources supporting physical, emotional, and financial well-being, based on eligibility.