CVS Health is seeking an Analyst, Case Mgt Field to support field-based care management and improve patient outcomes. In this role, you will analyze member data, track care plans, and support case managers serving complex, high-risk populations. Responsibilities include preparing reports, coordinating with clinical and social care teams, monitoring quality and compliance, and identifying barriers to care. You will leverage healthcare analytics tools, EMR/claims data, and documentation standards to drive efficient, patient-centered care while collaborating across teams in a purpose-driven, inclusive culture.
Responsibilities
- Analyze member and population data to identify risk, trends, and care gaps.
- Support field case managers with reporting, documentation, and care plan tracking.
- Prepare dashboards and operational reports for clinical and leadership teams.
- Monitor quality, utilization, and compliance with internal policies and regulations.
- Coordinate with clinical, social work, and community partners to resolve member issues.
- Maintain accurate, timely documentation in EMR and case management systems.
- Identify process improvements to streamline case management workflows.
- Use Excel and analytics tools to validate data and measure program impact.
- Support implementation of new care management initiatives and pilots.
- Uphold HIPAA, privacy, and data security standards in all activities.
Required Skills
- Healthcare data analysis
- Case management workflows
- Claims and EMR systems
- Care coordination support
- Reporting and dashboards
- Quality and compliance monitoring
- Excel and data tools
- Healthcare regulations (HIPAA)
- Stakeholder communication
- Process improvement
