PACE Health Plan Analyst & Compliance

Golden Valley Health Centers; Modesto (CA); On-site; USD 65,000 - 95,000; Full time

Benefits offered by this job

Medical benefits

403(b) with match

FSA plans

Gym discounts

Job summary

Golden Valley Health Centers is seeking a Health Plan Specialist to support data analysis, reporting, and modeling of health plan operations. You will help prepare pro formas, ensure regulatory compliance, and assist in audits and reimbursement processes.

The role involves coordinating with CMS and DHCS, preparing cost reports, and analyzing data trends to drive improvements in health plan performance. Monday–Friday, on-site in Modesto, CA.

Qualifications

• Proven analytical ability and problem-solving skills.
• Ability to collaborate well in a team.
• Capacity to learn quickly and adapt to new regulations.
• Advanced Microsoft Excel experience required.

Responsibilities

• Ensure CMS/DHCS regulatory compliance for health plan operations.
• Prepare Medicare and Medicaid cost reports and supporting information.
• Respond to CMS/DHCS inquiries and document submissions.
• Analyze data to support data-driven decision making.
• Assist in regulatory audits and reporting related to Medicare/MediCal.

Skills

Analytical ability

Team collaboration

Learning quickly

Microsoft Excel

Education

Associates degree in business/healthcare administration

High School Diploma or equivalent

Tools

Microsoft Office

Job description

Golden Valley Health Centers is seeking a Health Plan Specialist to support data analysis, reporting, and modeling of health plan operations. You will help prepare pro formas, ensure regulatory compliance, and assist in audits and reimbursement processes.

The role involves coordinating with CMS and DHCS, preparing cost reports, and analyzing data trends to drive improvements in health plan performance. Monday–Friday, on-site in Modesto, CA.