Workforce Management Analyst, Claims Operations

CVS Health Careers

. Analyze claims receipts, production, inventory, aging, staffing, productivity, and utilization trends to identify capacity needs, workload imbalances, and operational risks .

Posted 11/11/2026full-timeRemote • Minnesota • United StatesMid-LevelSenior💰 $21 - $41 per hourWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in workforce management and operations analytics, with a strong focus on capacity planning, forecasting, and claims operations. Proficient in translating operational data into actionable insights and recommendations for leadership.

Highest-signal resume keywords

Workforce ManagementOperations AnalyticsCapacity PlanningForecastingClaims Operations

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Data AnalysisOperational Metrics AnalysisForecast DevelopmentScenario ModelingClaims Inventory ManagementWorkload BalancingProductivity AnalysisUtilization AnalysisReporting Tools ProficiencySpreadsheet Proficiency

Soft Skills

Analytical SkillsProblem-Solving SkillsDecision-Making SkillsCommunication SkillsOrganizational Skills

Tools & Technologies

Workforce Management SystemsAnalytical PlatformsReporting ToolsDashboards

Industry Keywords

Health Care Claims OperationsHealth Insurance OperationsTransaction-Based OperationsOperational RisksStaffing Allocation

About the role

Key responsibilities & impact

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

What you’ll need

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

Comp & perks

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