Analyst II - Core Business Systems

Inland Empire Health Plan in Rancho Cucamonga, CA

  • Industry: Advertising/Marketing/Public Relations - Marketer/Market Researcher/Data Analyst
  • Type: Full Time
  • Compensation: $101,490.00 - 197,100.00 / Year*
Position Summary/ Purpose

Under the general supervision of the Core Business Systems Management, the Analyst II will assist in coordinating all regulatory requirements for audits. The position will also be responsible for variety of complex assignments that are delegated by management in terms of objectives rather than specific instructions. The Analyst II is responsible for supporting the Core Business Systems Management team in all required or directed activities.

Major Duties/ Responsibilities
  • Act as an Analyst for the Business Systems Management as follows:
    • Coordinate all department functions as requested
    • Act as liaison between the department and other IEHP departments
    • Coordinate and facilitate LEAN initiatives in alignment with IEHP Process Improvement efforts.
  • Gather and analyze requirements for and develop reports and operational processes.
  • Utilize Workfront system and processes to support operational strategies and reporting.
  • Facilitate and manage strategic and departmental focused projects.
  • Demonstrate a commitment to understand and adhere to the Regulatory requirements as they relate to the business unit(s).
  • Manage Professional Service Agreements and amendments, RFQs and RFPs
  • Responsible for the compilation, analyses, and preparation of Governing Board Staff Reports and Recommendations (Write-ups).
  • Develop policies and procedures related to job functions, procedures, and technical guidelines.
  • Track and analyze regulation changes and prepare for audits (NCQA, CMS, DMHC, DHCS)
  • Develop systems and processes to support operational strategies.
  • Any other duties as required to ensure Health Plan operations are successful.
  • Ensure the privacy and security of PHI (Protected Health Information) as outlined in IEHP s policies and procedures relating to HIPAA compliance.
  • Demonstrate a commitment to support IEHP s strategic priorities to become a 5-Star Health Plan.
  • Demonstrate commitment to Team Member Engagement by participating in projects/tasks/activities that promote Team Member excitement and enthusiasm for their role, increased work effort, and commitment to the organization.
Bachelor's degree required from an accredited institution. 3 - 5 years experience in Managed Care experience required.

Specialized Knowledge/Skills
  • Knowledge of Managed Care systems and client/server applications - Required
  • Knowledge of health plan business operations - Required
  • Experience working with Medicare/Medicaid government programs - Required
  • Proficient in Microsoft Office Suite programs including Visio - Required
  • Workfront reporting experience - Preferred
  • Project management understanding and skills - Required
  • Excellent written, and oral communication skills - Required
  • Experience successfully managing business relationships with stakeholders - Required
  • Principles and methods of systems analysis for data processing - Required
  • Principles of sound testing methodologies Preferred
  • Participated in the implementation and/or migration of a core claims system - Preferred
Abilities
  • Sound research techniques - Required
  • Proven analytical and problem-solving capabilities - Required
  • Ability to work independently, under pressure, balances multiple projects and deadline driven - Required
  • Ability follow-through and track all outstanding tasks and coordinate with assigned owners to ensure tasks are completed timely - Required
  • Ability to grasp new ideas and concepts quickly - Required
  • Ability to successfully present ideas in an audience-oriented manner Required
  • Ability to manage multiple projects of varying complexity, priority levels and deadlines - Required
Starting Salary: $54,724 - $69,784

Pay rate will commensurate with experience

Inland Empire Health Plan (IEHP) is the largest not-for-profit Medi-Cal and Medicare health plan in the Inland Empire. We are also one of the largest employers in the region. With a provider network of more than 6,000 and a team of more than 2,000 employees, IEHP provides quality, accessible healthcare services to more than 1.2 million members. And our mission and core values help guide us in the development of innovative programs and the creation of an award winning workplace. As the healthcare landscape is transformed, we re ready to make a difference today and in the years to come. Join our Team and Make a Difference with us! IEHP offers a Competitive salary and a benefit package with a value estimated at 35% of the annual salary, including medical, dental, vision, team bonus, and retirement plan.

Nearest Major Market: Riverside
Nearest Secondary Market: Los Angeles

* Estimated salary


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