Analyst II - Provider Contracting - Inland Empire Health Plan

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 an authentic experience!

 

The Analyst II - Provider Contracting is responsible for conducting statistical analyses for projects, initiatives, and strategies at the senior leadership level. This position is responsible for operations support, policy, procedure, including project development and implementation.  This position is critical in providing analytical support to each functional area in the Contracting Department, including data analysis and reporting in order to develop strategies to improve contracting functions and strategies. The Analyst II - Provider Contracting act as a liaison between teams within and outside the Contracting Department. The incumbent will assist in developing cross-functional collaborations, engage with external partners, if necessary, and develop special reports and projects.

 

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.

• 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:

1. Conduct thorough analysis of provider network based on current rates. Present findings and make recommendations for further analyses or any necessary projects.
2. Work closely with the Provider Network team in conducting thorough analysis and to ensure IEHP network adequacy.
3. Collaborate with the Actuarial team on pulling and analyzing data to support rate negotiations and/or rate equivalents.
4. Collaborate with the Provider Data Configuration team on pulling and analyzing data as it relates to Provider requests around non-standard contracts (exclusions, non-covered codes, etc.) and make recommendations as appropriate.
5. Create paid reporting and conduct claims analysis to identify utilization and make appropriate recommendations.
6. Produce and analyze reporting on contracted providers as it relates to contracting (# of non-standard, # of standard, lines of business, coverage areas, and provider types and specialties.). Present analyses to department senior leadership and take any appropriate action based on senior leadership feedback.
7. Coordinate management of new benefits that impacts the current and new contracts and manage any necessary project implementation.
8. Produce reports and analyses necessary to review Alternative Access Standards.
9. Play a key role in providing analyses to assist the department leadership and providing recommendations for the development of business processes, planning and implementation to support the Contracting Department and IEHP Mission and Vision.
10. Collaborate with the IT Department on the development of systems to support the Contracting Department business needs.
11. Ensure adherence and compliance with IEHP’s policies, rules and regulations relating to safety/health, performance standards, operating procedures, processes, and training requirements.
12. Any other duties as required ensuring Health Plan operations are successful.

Qualifications:

Education & Experience

• Four (4) years of experience in operational areas working with Power BI, SQL Server and reporting, and Microsoft Access
  • Preferably within a healthcare setting
• Bachelor's degree from an accredited institution required

 

Key Qualifications

• Thorough knowledge of Medi-Cal and Medicare managed care. Strong knowledge of project management and cross-organization coordination
• Knowledge of provider contracting preferred
• Strong written and oral communication skills
• Strong organizational skills and sound decision-making skills required 
• Highly analytical and capable of translating analytical insights into action
• Strong time management skills
• Ability to manage multiple projects of varying complexity, priority levels and meet deadlines
• Ability to gather and analyze data in a detailed and highly organized manner
• Ability to work and communication effectively with team members at all levels of organizations
• Ability to work independently in a deadline-driven environment

 

Start your journey towards a thriving future with IEHP and apply TODAY!

Work Model Location:

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

Pay Range:USD $34.41 - USD $44.73 /Hr.