Workforce Management Analyst, Claims Operations

Job not on LinkedIn

🔥 16 hours ago

❄️ Minnesota – Remote

❄️ Minnesota – Remote

💵 $21 - $40 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

🧐 Business Analyst

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CVS Health Careers

WebsiteLinkedInAll Job Openings

10,000+ employees

🏥 Healthcare

🛒 Retail

📦 Logistics

Healthcare • Retail • Logistics

CVS Health Careers is the recruitment and employer branding arm of CVS Health, showcasing job opportunities across the company's broad operations—pharmacy retail stores, pharmacy services, health care clinics, distribution warehouses, corporate functions and transportation. The careers site emphasizes purpose-driven work focused on improving access, affordability and quality of health care, and highlights a large workforce (300,000+ employees), inclusive culture, benefits, and hiring resources for applicants.

📋 Description

• Analyze claims receipts, production, inventory, aging, staffing, productivity, and utilization trends to identify capacity needs, workload imbalances, and operational risks • Develop and maintain Claims Operations demand and capacity forecasts using historical volumes, production trends, staffing assumptions, employee ramp, PTO/LOA, overtime, and other operational factors • Build and maintain capacity models comparing productive capacity with projected claims demand and inventory requirements • Support claims inventory and forecasting, including projected receipts, completions, inventory movement, and capacity scenarios across claims work types and inventory segments • Monitor workforce utilization and evaluate production and non-production activities • Evaluate workload distribution across Claims teams and identify opportunities to improve staffing allocation, workload balancing, productivity, and specialized claims skills utilization • Partner with Claims leadership to align available capacity with operational priorities • Perform scenario modeling for changes in staffing, overtime, vendor capacity, training/ramp assumptions, utilization, automation, productivity, and incoming claims volume • Develop recurring reporting and workforce insights on capacity versus demand, inventory trends, productivity, utilization, staffing, and emerging operational risks • Translate workforce and operational data into recommendations for Claims Operations leadership • Partner with Claims leadership and cross-functional stakeholders on staffing and workforce strategies • Improve forecasting, reporting, workload management, resource utilization, and workforce planning processes, including automation and analytical tools • Support workforce planning methodologies, metric definitions, documentation, and governance across Claims Operations

🎯 Requirements

• Minimum of 3 years of experience in workforce management, operations analytics, capacity planning, forecasting, claims operations, or a related operational role • Experience analyzing operational data and translating findings into actionable recommendations • Demonstrated proficiency working with data, spreadsheets, reporting tools, workforce management systems, or similar analytical platforms • Strong analytical, problem-solving, and decision-making skills • Strong communication, information management, and organization skills with the ability to collaborate effectively across operational and functional teams • Proactive self-starter who takes ownership, quickly learns new concepts, identifies opportunities for improvement, and independently drives issues toward resolution • High school diploma or GED • Experience supporting health care claims operations, health insurance operations, or another transaction-based operational environment • Experience with claims inventory management, production forecasting, capacity planning, workload balancing, or workforce utilization analysis • Experience developing forecasts or scenario models using volumes, productivity, staffing, and capacity assumptions • Experience analyzing operational metrics such as receipts, completions, inventory aging, productivity, utilization, staffing levels, and service performance • Experience creating reports, dashboards, or operational analyses used to support leadership decision-making • Ability to identify emerging workforce or inventory risks and translate data into practical operational recommendations

🏖️ Benefits

• CVS Health bonus, commission or short-term incentive program in addition to base pay • Medical coverage • Dental coverage • Vision coverage • Paid time off • Retirement savings options • Wellness programs • Other resources supporting physical, emotional, and financial well-being, based on eligibility

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