Analyst III - Member Services

Inland Empire Health Plan; Rancho Cucamonga (CA); Hybrid; USD 80,000 - 106,000; Full time

Benefits offered by this job

Competitive salary

Hybrid schedule

CalPERS retirement

457(b) match

PTO

Fitness center on-site

Medical insurance (Dental & Vision)

Life insurance

Disability insurance

Pet care insurance

Flexible Spending Account

Wellness programs

Career development

Annual merit increase

Team bonuses

Job summary

Inland Empire Health Plan seeks an Analyst III to coordinate all regulatory requirements for audits under the Senior Director of Member Services. The role involves handling complex assignments and supporting activities to ensure compliance and quality.

This hybrid position is based in Rancho Cucamonga, CA, with remote work on Mon & Fri and onsite Tue–Thu. The role offers a competitive salary and comprehensive benefits including retirement, health coverage, and professional development

Qualifications

• Three or more years of experience as an Analyst required.
• Bachelor’s degree required.
• Three or more years of Analyst experience in health care preferred.

Responsibilities

• Coordinate all regulatory requirements for audits.
• Assist in coordinating complex assignments delegated by management.
• Support Senior Director of Member Services in required activities.
• Help enforce quality and regulatory program goals (HEDIS, CAHPS, NCQA).
• Coordinate and participate in LEAN/continuous improvement initiatives.

Skills

Strong verbal and writtencommunication

Analytical skills

Health care experience

Education

Bachelor’s degree

Job description

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 anauthentic experience!

Under the general supervision of the Senior Director of Member Services, the Analyst III 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 III is responsible for supporting the Senior Director in all required or directed activities.

Commitment to Quality: The IEHP Team is committed to incorporate IEHP’s Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation.

Additional Benefits

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.

• Competitive salary.
• Hybrid schedule.
• 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

Key Responsibilities

• Project Related Responsibilities
  • Quickly understands the business issues and data challenges of organization and industry
  • Identifies department’s strengths and weaknesses and suggests areas of improvement
  • Reviews and edits requirements, specifications, business processes and recommendations related to proposed solution
  • Assists in enforcement of project deadlines and schedules
  • Take input from Senior Director and appropriately and accurately applies comments/feedback.
  • Organizational analysis including planning and scoping Organizational initiatives and assisting Senior Director to make informed decisions about which initiatives to tackle and how to tackle them
  • Manage Projects: Strategic and departmental focused
  • Manage Programs at the organizational level
• Roles and Related Responsibilities
  • Provide mentoring to fellow Business Analysts
  • Coordinate the work of other BAs as related to specific projects
  • Provide assistance to team members and peers by collaborating with others; articulating ideas and viewpoints to senior management, peers and others; identifying and initiating projects; managing resources; driving the resolution of issues; and holding self and team accountable for results
  • Meet with project team regularly to review project deliverables and deadlines
• Act as an assistant for the Senior Director of Member Services as follows:
  • Coordinate all department functions as requested
  • Act as liaison between the department and other IEHP departments
  • Prepare special reports
  • Develop department reporting needs
  • Coordinate and participate in RIE Events for Member Experience Transformation Work (Simpler)
• Facilitate and assist with LEAN initiatives Facilitate and manage operational projects using A3 thinking and lean concepts
• Coordinate and prepare documentation for all audits
• Compile, analyze, and prepare annual budget reports
• Manage Professional Service Agreements and amendments. Manage RFQs and RFPs
• Responsible for the compilation, analyses, and preparation of Governing Board Staff Reports and Recommendations (Write-ups)
• Assist in the development of internal and external policies and procedures.
• Track and analyze regulation changes and prepare for audits (NCQA, CMS, etc.)
• Responsible for writing training materials, working in a team setting with other team members, as well as subject matter experts within IEHP to develop new training materials and enhance existing resources
• Responsible for the compilation of data, and data and information analysis
• Develop systems and processes to support operational strategies.
• Requires general knowledge of concepts, practices, and procedures within a specified field
• Analyze requirements for custom reports and operational processes
• Demonstrate a commitment to understand and adhere to the Regulatory requirements as they relate to the business unit(s)
• 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

Qualifications

Education & Experience

• Three (3) or more years of experience as an Analyst required
• Bachelor’s degree from an accredited institution required

Key Qualifications

• Strong verbal and written communication skills
• Analytical skills with emphasis on regulatory interpretations and problem solving
• Three (3) or more years experience as an Analyst in health care preferred. Prior office experience or experience in a managed care environment preferred.

Work Model Location

This position is on a hybrid work schedule. (Mon & Fri - remote, Tues - Thurs onsite in Rancho Cucamonga, CA)

Pay Range

USD $80,059.20 - USD $106,059.20 /Yr.