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Care Management Operations Analyst

United States 72800.00 - 91000.00 USD / Year · Job Posted March 13, 2026
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Job Description

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.

Job Responsibility

  • 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 staff
  • 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
  • Serves as a subject matter expert across CM, CDM, and UM workflows
  • Serves as a mentor
  • Independently analyzes and redesigns workflows to improve efficiency and outcomes
  • Development of scripts and automated tools
  • 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
  • Demonstrate expert-level proficiency in Microsoft Office Suite, Share Point, Power BI, Air Table

Requirements

  • Bachelor’s degree preferred, or minimum three years of formal training experience in health care service capacity
  • Demonstrated success leading or contributing to cross‑functional process improvement initiatives
  • Experience developing or supporting automation, workflow optimization, or reporting enhancements
  • Ability to translate ambiguous operational needs into clear process or technical requirements
  • Experience supporting complex implementations, regulatory changes, or client onboarding activities
  • Working knowledge of standard office software and systems
  • The ability to work on multiple screens, and proficient typing skills
  • Proficiency in software applications including, but not limited to, Microsoft Word, Microsoft Excel, and Outlook
  • Ability to speak clearly and convey complex or technical information in a manner that others can understand, as well as ability to understand and interpret complex information from others
  • Ability to work independently and utilize written resources to solve problems
  • Knowledge of medical claims and ICD-10, CPT, HCPCS coding
  • Excellent verbal and written communication skills for upward and downward conversations
  • 3-5 years’ experience of managed care experience

What we offer

  • Competitive base salary and benefits effective day one
  • Comprehensive medical and dental through our own health solutions
  • Unlimited PTO
  • Mental health support, retirement planning, and financial protection
  • Professional development with clear career progression and learning budgets
  • Mission-driven culture where diverse perspectives drive real impact on people's health

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