Regulatory Affairs Analyst II

7 days ago


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

We are seeking a highly skilled Regulatory Affairs Analyst II to join our team at Inland Empire Health Plan. As a key member of our Compliance Department, you will play a critical role in ensuring our plan operations, processes, and procedures are in compliance with regulatory agencies, including Covered California, CMS, DHCS, and DMHC.

Key Responsibilities
  • Interpret and apply contract, legislative, and regulatory requirements affecting multiple departments within the plan.
  • Communicate new and revised laws and regulatory guidance to the plan, interpret and summarize requirements, and analyze responses.
  • Ensure plan lines of business are in compliance with contracts, licenses, and regulatory agencies, and develop recommendations for appropriate action.
  • Review and analyze compliance issues and inquiries from internal departments and regulatory agencies, and provide accurate responses and recommendations.
  • Collaborate with internal departments to ensure compliance with reporting and submission requirements to regulatory agencies.
  • Analyze and interpret the Knox-Keene Act, identify eFiling and submission requirements, and prepare 1352(a) Amendments and Material Modifications for submission.
  • Report potential risks, non-compliance, or alleged violations to the Director of Compliance.
  • Assist in preparing the plan for regulatory audits and participate in other components of the compliance program.
Commitment to Quality

We are committed to incorporating IEHP's Quality Program goals, including HEDIS, CAHPS, and NCQA Accreditation, into our daily work.

Additional Benefits

We offer a competitive salary, hybrid schedule, CalPERS retirement, state-of-the-art fitness center, medical insurance, life and disability options, career advancement opportunities, and wellness programs.



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