Case Management Data Analyst

As an Analyst, Case Management at CVS Health, you will analyze clinical and claims data to support coordinated patient care and utilization management. You'll evaluate case workflows, identify trends, and help optimize care plans to improve outcomes and reduce costs. Partnering with nurses, social workers, and pharmacists, you'll prepare reports, track quality metrics, and recommend process improvements. You'll work within an inclusive, purpose-driven culture with opportunities for growth, training, and nationwide career mobility in healthcare and related fields.

Responsibilities

• Analyze clinical, claims, and utilization data to support case management decisions
• Monitor and report on key quality and performance metrics for patient care programs
• Identify trends, gaps, and opportunities to enhance care coordination and outcomes
• Develop dashboards, reports, and presentations for clinical and business stakeholders
• Collaborate with nurses, social workers, pharmacists, and operations teams
• Support process improvement initiatives in case management workflows
• Ensure adherence to healthcare regulations, privacy, and compliance standards
• Provide data-driven insights to inform program design and strategic decisions

Required Skills

• Healthcare data analysis
• Case management workflows
• Utilization management
• Claims and clinical data reporting
• Excel and data visualization tools
• SQL or similar query tools
• Healthcare regulations and compliance
• Quality and performance metrics
• Process improvement
• Stakeholder communication