Managed Care Analyst I

Artisan Field, Inc.; Apple Valley (CA); On-site; USD 31,684 - 38,021; Full time

Benefits offered by this job

401k matching

Paid Time Off

Medical benefits

Dental benefits

Vision insurance

Supplemental options

Job summary

A managed care organization is seeking a Managed Care Analyst I for its Apple Valley, CA location. In this role, you'll maintain the accuracy of eligibility and capitation data, resolve issues across departments, and ensure compliance with requirements. The ideal candidate possesses strong analytical skills, a commitment to teamwork, and experience in healthcare. Competitive benefits and a collaborative environment await you.

Qualifications

• Minimum of three (3) years of healthcare experience and/or training required.
• Ability to learn new systems quickly.
• Proven ability to manage multiple priorities and deadlines.

Responsibilities

• Maintain eligibility files using multiple electronic platforms.
• Research and resolve eligibility issues for UM/QM and Claims Departments.
• Reconcile Eligibility and Capitation reports.

Skills

Analytical skills

Attention to detail

Problem-solving

Communication skills

Team player

Education

High School Diploma

Bachelor’s Degree or equivalent

Tools

EZ-Cap

Microsoft Office Suite (Excel, Outlook, Word)

Job description

1 day ago Be among the first 25 applicants

Get AI-powered advice on this job and more exclusive features.

Artisan Field, Inc. provided pay range

This range is provided by Artisan Field, Inc.. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more.

Base pay range

$23.00/hr - $27.60/hr

We’re a collaborative, patient-focused organization dedicated to excellence in managed care and provider support. In this role, you’ll have the opportunity to grow your analytical expertise, contribute to cross‑functional process improvements, and be part of a team that values precision, integrity, and teamwork.

The Managed Care Analyst I plays a vital role in maintaining the accuracy and integrity of eligibility and capitation data across multiple systems. This position serves as a key liaison between internal departments, health plans, and employer groups to ensure smooth operations, timely issue resolution, and compliance with managed care requirements. The ideal candidate is highly analytical, detail-oriented, and thrives in a fast‑paced, team‑driven environment.

Key Responsibilities

• Maintain eligibility files using multiple electronic platforms including Eddie, Bowman, and EZ‑Net.
• Research and resolve eligibility issues for UM/QM and Claims Departments.
• Reconcile Eligibility and Capitation reports to ensure data accuracy.
• Update misassigned and unassigned member information to ensure accurate PCP capitation.
• Communicate with health plans and employer groups to verify and update eligibility information.
• Download and review reports from health plans for eligibility verification.
• Assist in identifying benefit plan codes and verifying benefits, including the input of copays, coinsurance, and deductibles.
• Research and resolve requests from the Finance Department regarding PCP assignment changes, terminations, or additions.
• Act as a liaison for PCPs, specialists, and clients to verify eligibility and document resolutions.
• Provide claim details to health plans for Workers’ Compensation requests.
• Research eligibility for Revenue Recovery inquiries and projects.

Qualifications

• High School Diploma required; Bachelor’s Degree desirable or equivalent combination of education and experience.
• Minimum of three (3) years of healthcare experience and/or training required.
• Familiarity with EZ‑Cap and Microsoft Office Suite (Excel, Outlook, Word); ability to learn new systems quickly.
• Strong analytical and problem‑solving skills with high attention to detail.
• Excellent oral and written communication skills; able to communicate professionally with all levels of staff and external partners.
• Proven ability to manage multiple priorities and meet deadlines in a fast‑paced environment.
• Demonstrated professionalism, diplomacy, and trustworthiness.
• Positive attitude and strong team player.
• Ability to negotiate, problem‑solve, and make independent decisions as needed.
• Competitive benefits package that includes 401k matching, Paid Time Off, Medical, Dental, Vision, and supplemental options.

Seniority level: Mid‑Senior level

Employment type: Full‑time

Job function: Health Care Provider

Industries: Graphic Design

Referrals increase your chances of interviewing at Artisan Field, Inc. by 2x

Get notified about new Healthcare Analyst jobs in Apple Valley, CA.

We’re unlocking community knowledge in a new way. Experts add insights directly into each article, started with the help of AI.