Analyst III - Member Services

Inland Empire Health Plan•Rancho Cucamonga, CA

15d•$80,059 - $106,059•Hybrid

About The Position

Under the general supervision of the Senior Director of Member Services, the Analyst III coordinates regulatory requirements for audits and handles complex assignments delegated by management based on objectives rather than detailed instructions. The role supports the Senior Director in required and directed activities and contributes to IEHP’s Quality Program goals, including HEDIS, CAHPS, and NCQA Accreditation. The position leads and supports strategic and departmental projects and organization-level programs; analyzes business issues, data challenges, requirements, and operational processes; coordinates project schedules and deliverables; and helps identify organizational improvements. It also supports department operations through reporting, budget preparation, contract and procurement administration, audit preparation, policy and procedure development, regulatory tracking, training materials, and operational systems and processes. This position follows a hybrid schedule: remote on Monday and Friday, and onsite Tuesday through Thursday in Rancho Cucamonga, California. The stated annual pay range is USD $80,059.20–$106,059.20.

Requirements

At least three years of experience as an Analyst.
Bachelor’s degree from an accredited institution.
Strong verbal and written communication skills.
Analytical skills, particularly in regulatory interpretation and problem-solving.
General knowledge of concepts, practices, and procedures within a specified field.

Nice To Haves

At least three years of experience as an Analyst in health care.
Prior office experience.
Experience in a managed care environment.

Responsibilities

Understand business issues and data challenges affecting the organization and industry.
Identify departmental strengths and weaknesses and recommend areas for improvement.
Review and edit requirements, specifications, business processes, and recommendations related to proposed solutions.
Help enforce project deadlines and schedules, and apply feedback from the Senior Director accurately.
Conduct organizational analysis, including planning and scoping initiatives, and assist the Senior Director in prioritizing and executing initiatives.
Manage strategic and department-focused projects and organization-level programs.
Mentor fellow Business Analysts and coordinate their work on specific projects.
Collaborate with team members and peers; communicate ideas to management and colleagues; initiate projects; manage resources; resolve issues; and maintain accountability for results.
Meet regularly with project teams to review deliverables and deadlines.
Coordinate department functions and act as a liaison between Member Services and other IEHP departments.
Prepare special reports and develop department reporting needs.
Coordinate and participate in RIE Events for Member Experience Transformation Work (Simpler).
Facilitate LEAN initiatives and manage operational projects using A3 thinking and LEAN concepts.
Coordinate and prepare audit documentation.
Compile, analyze, and prepare annual budget reports.
Manage Professional Service Agreements and amendments, and manage RFQs and RFPs.
Compile, analyze, and prepare Governing Board Staff Reports and Recommendations (Write-ups).
Assist in developing internal and external policies and procedures.
Track and analyze regulatory changes and prepare for audits, including NCQA and CMS audits.
Develop and enhance training materials in collaboration with team members and subject matter experts.
Compile data and analyze data and information.
Develop systems and processes that support operational strategies.
Analyze requirements for custom reports and operational processes.
Understand and adhere to regulatory requirements applicable to the business unit or units.
Participate in projects, tasks, and activities that support Team Member engagement.