Care Management Operations Analyst

Overview Ready To  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.  What You'll Actually Do  • 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 • 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