Analyst I

3 weeks ago

Rancho Cucamonga, United States Inland Empire Health Plan Full time

**What you can expect**

Find joy in serving others with IEHP We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an **authentic experience**

Under the direction of the Manager, Regulatory Affairs, the Analyst I - Regulatory Affairs (Policy & Communications) has a general knowledge of and performs key centralized regulatory activities of moderate difficulty for the Compliance Department. Team Members in this position ensure Plan operations, processes, procedures, policies, etc. are in compliance with regulatory agencies, including but not limited to, the Centers for Medicare and Medicaid Services (CMS), the California Department of Health Care Services (DHCS), and the California Department of Managed Health Care (DMHC), in addition to collaboration with, inter-departments to ensure member needs are met while simultaneously building strong peer relationships.

**Key Responsibilities**

1. Serve as the Plan’s internal Compliance point of contact for Regulatory Affairs matters.

2. Communicate new and revised laws and regulatory guidance that affect the Plan and interpret/summarize the requirements. Disseminate the requirements and analyze the responses. Participates in workgroups to assist internal departments in making administrative and operational decisions.

3. Monitors the Plan’s lines of business adherence to contract(s) with the CMS, contract(s) with the DHCS, Knox-Keene license(s) with the DMHC, and any other applicable regulatory agencies.

4. Triage compliance issues and inquiries from internal departments and applicable regulatory agencies, understand the underlying intent of the questions, and perform necessary research and analysis to provide accurate responses and recommendations.

5. May assist in ensuring compliance with the Plan’s lines of business reporting and submission requirements to the CMS, the DHCS, the DMHC, and any other applicable regulatory agencies. May be responsible for receiving, researching, coordinating, responding timely and tracking all inquiries and submissions to the CMS, the DHCS, the DMHC, and any other applicable regulatory agencies.

6. Prepare 1352(a) Amendments and Material Modifications for submission to the DMHC. Receive, coordinate and respond timely to all subsequent Comment Letters and amendments.

7. Report potential risks, non-compliance or alleged violations to the Director of Compliance.

8. Under the direction of the Manager, Regulatory Affairs assist in preparing the Plan for regulatory audits.

9. May support other components of the Plan’s compliance program, such as Privacy, Data Security, Code of Business Conduct and Ethics, Fraud Waste & Abuse, etc.

10. Attend relevant committees and work groups; may develop reports and presentations based on the analysis of collected data.

11. Proactively identify areas of improvement for the Compliance Department and participate in development of performance improvement initiatives.

12. Assist with the maintenance of external and internal policies and procedures.

**Perks**

IEHP is not only committed to healing and inspiring the human spirit of our Members; we also aim to match our Team Members with the same energy by providing prime benefits and more.
- CalPERS retirement
- 457(b) option with a contribution match
- Generous paid time off
- vacation, holidays, sick
- State of the art fitness center on-site
- Medical Insurance with Dental and Vision
- Paid life insurance for employees with additional options
- Short-term, and long-term disability options
- Pet care insurance
- Flexible Spending Account - Health Care/Childcare
- Wellness programs that promote a healthy work-life balance
- Career advancement opportunities and professional development
- Competitive salary with annual merit increase
- Team bonus opportunities

**Education & Experience**
- One (1) year of experience with managed care or other relevant industry experience
- Experience in health care, health plans, Medicaid Managed Care Plans (MCPs), Medicare Advantage, Medicare Part D, Special Needs Plans (SNPs), and/or Medicare-Medicaid Plans (MMPs)/Cal MediConnect
- Experience interacting with regulatory agencies
- Bachelor’s degree from an accredited institution required

**Key Qualifications**
- Valid California Driver's license and valid automobile insurance. Must qualify and maintain driving record to drive company vehicles based on IEHP insurance standards of no more than three (3) points
- Knowledge of and experience with state and Federal regulatory and other requirements and practices related to Medicare and Medi-Cal (Medicaid), Title 19 (USC)/Title 29 (USC and CCR), Title 22 (CCR), Title 28 (CCR), Title 42 (USC and CFR), CA Welfare and Institutions Code, and CA Health and Safety Code
- Microsoft Office programs including, but not limited to, Word, Excel, PowerPoint, Outlook, and Access

  • Financial Analyst I

    4 weeks ago

    Rancho Cucamonga, United States Inland Empire Health Plan Full time

    Overview: **What you can expect!** Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience! Under the direction of department leadership, the Financial Analyst I - Financial Compliance is responsible performing analysis and preparing...

  • Analyst I

    2 days ago

    Rancho Cucamonga, United States Inland Empire Health Plan Full time

    Overview: What you can expect! Find joy in serving others with IEHP! We welcome you to join us in healing and inspiring the human spirit and to pivot from a job opportunity to an authentic experience! Under the direction of Health Equity Operations leadership, the Analyst I - Health Equity Operations is responsible for the development, monitoring and...

  • Financial Analyst I – Financial Compliance

    6 days ago

    Rancho Cucamonga, California, United States Inland Empire Health Plan Full time

    Overview: What you can expect!    Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience!   Under the direction of department leadership, the Financial Analyst I - Financial Compliance is responsible performing analysis and...

  • Financial Analyst I – Financial Compliance

    3 weeks ago

    Rancho Cucamonga, California, United States Inland Empire Health Plan Full time

    Overview: What you can expect!    Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience!   Under the direction of department leadership, the Financial Analyst I - Financial Compliance is responsible performing analysis and...

  • Financial Analyst I – Financial Compliance

    4 weeks ago

    Rancho Cucamonga, California, United States Inland Empire Health Plan Full time

    Overview: What you can expect!    Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience!   Under the direction of department leadership, the Financial Analyst I - Financial Compliance is responsible performing analysis and...

  • Analyst III

    3 weeks ago

    Rancho Cucamonga, United States Inland Empire Health Plans Full time

    What you can expect! Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience! The Analyst III – Compliance Program has expert knowledge and performs key Compliance Program activities of complex difficulty. Team Members in this...

  • Analyst I

    1 week ago

    Rancho Cucamonga, California, United States Inland Empire Health Plan Full time

    Overview: What you can expect!    Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience!   Under the direction of Health Equity Operations leadership, the Analyst I - Health Equity Operations is responsible for the...

  • Quality Systems Analyst l

    3 weeks ago

    Rancho Cucamonga, California, United States Inland Empire Health Plan Full time

    Overview: What You Can You Expect?   Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience!     The Quality Systems Analyst I, under the guidance of the Quality Systems Leadership Team, brings excitement to IEHP’s Medical...

  • Financial Analyst-Innovative Strategy and Capital Fundraising

    5 days ago

    Rancho Cucamonga, United States National Community Renaissance Full time

    Job DescriptionJob DescriptionWe are seeking a proactive and innovative Financial Analyst- Innovative Strategy & Capital Fundraising to join our team, focusing on capital fundraising initiatives and incorporating cutting-edge solutions, including AI, to optimize our operations. This role will report to the Vice President of Finance and Acquisitions and will...

  • Financial Analyst-Innovative Strategy and Capital Fundraising

    1 week ago

    Rancho Cucamonga, United States National Community Renaissance Full time

    Job DescriptionJob DescriptionWe are seeking a proactive and innovative Financial Analyst- Innovative Strategy & Capital Fundraising to join our team, focusing on capital fundraising initiatives and incorporating cutting-edge solutions, including AI, to optimize our operations. This role will report to the Vice President of Finance and Acquisitions and will...

  • Healthcare Data Analyst I- Quality Systems

    2 weeks ago

    Rancho Cucamonga, United States IEHP Full time

    What You Can You Expect? Find joy in serving others with IEHP! We welcome you to join us in "healing and inspiring the human spirit" and to pivot from a "job" opportunity to an authentic experience! Be the data maestro! As a Healthcare Data Analyst, you'll decode data mysteries, wielding Microsoft Apps, SAS, and SPSS like magic wands. Craft reports with...

  • Analyst I

    2 weeks ago

    Rancho Cucamonga, California, United States Inland Empire Health Plan Full time

    Overview: What you can expect!    Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience!   Under the direction of the Supervisor of Provider Data Configuration, the Analyst is responsible for managing the front-end...

  • Analyst II

    3 weeks ago

    Rancho Cucamonga, United States Inland Empire Health Plans Full time

    What you can expect! Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience! The Analyst II, Regulatory Affairs has experience with and performs key centralized complex and difficult regulatory activities for the Compliance...

  • Analyst I

    3 weeks ago

    Rancho Cucamonga, California, United States Inland Empire Health Plan Full time

    Overview: What you can expect!    Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience!   Under the direction of the Manager, Regulatory Affairs, the Analyst I - Regulatory Affairs (Policy & Communications) has a general...

  • Analyst I

    6 days ago

    Rancho Cucamonga, California, United States Inland Empire Health Plan Full time

    Overview: What you can expect!    Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience!   Under the direction of the Manager, Regulatory Affairs, the Analyst I - Regulatory Affairs (Policy & Communications) has a general...

  • Controller/Finance Manager

    3 weeks ago

    Rancho Cucamonga, United States Option One Plumbing Full time

    Job DescriptionJob Description******New Year, New Career******Full Job DescriptionThe Controller is a key role in helping to drive the organization to achieve strategic and plan objectives. The Controller will be responsible for leading all aspects of the companies finance activities, including Managerial accounting, cost accounting, financial analysis,...

  • Solutions Developer

    5 days ago

    Rancho Cucamonga, United States IEHP Full time

    What You Can You Expect?Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience!The Solution Developer I- Automation & Innovation Management focuses on cutting-edge tech domains, solving complex business issues through AI, ML, and RPA....

  • Solutions Developer

    4 days ago

    Rancho Cucamonga, United States IEHP Full time

    What You Can You Expect?Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience!The Solution Developer I- Automation & Innovation Management focuses on cutting-edge tech domains, solving complex business issues through AI, ML, and RPA....

  • Solutions Developer

    5 days ago

    Rancho Cucamonga, United States IEHP Full time

    What You Can You Expect?Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience!The Solution Developer I- Automation & Innovation Management focuses on cutting-edge tech domains, solving complex business issues through AI, ML, and RPA....