Care Management Operations Analyst
Overview
Ready To
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The Care Management Operations Analyst serves as a subject matter expert and process leader, optimizing non‑clinical workflows across CM, CDM, and UM programs while advancing standardization, system improvements, and operational performance.
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What You'll Actually Do
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• Analyze and support end-to-end non-clinical workflows across CM, CDM, and UM programs
• Translate operational and clinical requirements into process maps, functional requirements, SOPs, and job aids
• Identify workflow gaps, inefficiencies, and risks impacting throughput, turnaround time, or documentation quality
• Support intake, referral, authorization, follow-up, and task management workflows
• Develop and maintain operational reporting, dashboards, and performance metrics
• Support workflow automation and system optimization initiatives
• Support planning, testing, and release activities for system and process changes
• Support implementation of new tools, enhancements, regulatory requirements, or client initiatives
• Partner with clinical, quality, IT, and analytics teams to ensure operational alignment
• Support audit and compliance readiness through process standardization and traceability
• Supports established workflows with guidance
• Documents business processes, requirements, and procedural updates
• Assists with reporting, data validation, and workflow monitoring
• Participates in automation and improvement initiatives as a contributor
• Builds foundational knowledge of CM, CDM, and UM operations
• Maintains high-level of understanding of regulations to support staff education
• Remain current with best practice models and current processes to be able to provide instruction to staffÂ
• Maintains high-level of cohesiveness within the team and professionalism as a representative of the department
• Other related duties as assigned to meet departmental and Company objectives
• Demonstrate proficiency in Microsoft Office Suite
• Ability to meet productivity, quality, and turnaround times daily
• Maintain HIPAA compliance and confidentiality in accordance with company policies
• Complete all required annual training within designated timeframes
• Same as level I with additional expectations and training in the department
• Serves as a subject matter expert across CM, CDM, and UM workflows
• 3-5 years experience of managed care experience
• Serves as a mentor
• Independently analyzes and redesigns workflows to improve efficiency and outcomes
• Development of scripts and automated tools
• Same as level I and Level II with additional expectations and training in the department
• Leads process improvement and automation initiatives
• Designs advanced reporting, analytics, and dashboards
• Translates ambiguous requirements into functional and technical deliverables
• Anticipates operational risk and downstream workflow impacts
• Supports complex implementations, audits, and regulatory initiatives independently
• Develops automation scripts and technical solutions to support operational workflows
• Understands the complexities of teaching a wide variety of staff and adapts teaching skills and level to audience
Apply tot his job
Apply To this Job
Ready To
Â
The Care Management Operations Analyst serves as a subject matter expert and process leader, optimizing non‑clinical workflows across CM, CDM, and UM programs while advancing standardization, system improvements, and operational performance.
Â
What You'll Actually Do
Â
• Analyze and support end-to-end non-clinical workflows across CM, CDM, and UM programs
• Translate operational and clinical requirements into process maps, functional requirements, SOPs, and job aids
• Identify workflow gaps, inefficiencies, and risks impacting throughput, turnaround time, or documentation quality
• Support intake, referral, authorization, follow-up, and task management workflows
• Develop and maintain operational reporting, dashboards, and performance metrics
• Support workflow automation and system optimization initiatives
• Support planning, testing, and release activities for system and process changes
• Support implementation of new tools, enhancements, regulatory requirements, or client initiatives
• Partner with clinical, quality, IT, and analytics teams to ensure operational alignment
• Support audit and compliance readiness through process standardization and traceability
• Supports established workflows with guidance
• Documents business processes, requirements, and procedural updates
• Assists with reporting, data validation, and workflow monitoring
• Participates in automation and improvement initiatives as a contributor
• Builds foundational knowledge of CM, CDM, and UM operations
• Maintains high-level of understanding of regulations to support staff education
• Remain current with best practice models and current processes to be able to provide instruction to staffÂ
• Maintains high-level of cohesiveness within the team and professionalism as a representative of the department
• Other related duties as assigned to meet departmental and Company objectives
• Demonstrate proficiency in Microsoft Office Suite
• Ability to meet productivity, quality, and turnaround times daily
• Maintain HIPAA compliance and confidentiality in accordance with company policies
• Complete all required annual training within designated timeframes
• Same as level I with additional expectations and training in the department
• Serves as a subject matter expert across CM, CDM, and UM workflows
• 3-5 years experience of managed care experience
• Serves as a mentor
• Independently analyzes and redesigns workflows to improve efficiency and outcomes
• Development of scripts and automated tools
• Same as level I and Level II with additional expectations and training in the department
• Leads process improvement and automation initiatives
• Designs advanced reporting, analytics, and dashboards
• Translates ambiguous requirements into functional and technical deliverables
• Anticipates operational risk and downstream workflow impacts
• Supports complex implementations, audits, and regulatory initiatives independently
• Develops automation scripts and technical solutions to support operational workflows
• Understands the complexities of teaching a wide variety of staff and adapts teaching skills and level to audience
Apply tot his job
Apply To this Job