Compliance Technical Analyst III - Rancho Cucamonga, United States - Inland Empire Health Plans

Inland Empire Health Plans Rancho Cucamonga, United States

4 weeks ago

Description

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 Compliance Technical Analyst III is responsible for owning the development, maintenance, and implementation of compliance systems, initiatives, projects, and other key systems and data driven activities within the Compliance department and the organization.

The Compliance Technical Analyst III works cross-functionally with department leaders to deliver strategically designed applications and actionable analyses / results.

The position leads and executes complex technical, analytical, and reporting efforts of complex programs, systems, and special projects.

Individuals in this classification demonstrate a significant degree of independence performing a variety of responsibilities for administering and managing systems and reporting to promote and ensure compliance with governmental, regulatory, or organizational mandates.

Key Responsibilities

Oversee, design, and maintain systems and applications by working collaboratively with leaders and staff to align functionality with compliance and regulatory needs.
Design and enhance systems, applications, and databases to support programs, processes, daily work, reporting, and analysis needs including, but not limited to, testing, validating, and maintaining data integrity and accuracy.
Act as the subject matter expert for systems, project development, and program management, including bridging the gap between processes and data management.
Research and analyze programs, applications, and processes to recommend designs, efficient procedures, and actions plans. Demonstrate a commitment to incorporate LEAN principles into daily work.
Serve as technical lead in analysis and reporting efforts that support the Compliance teams and organizational activities.
Develop and determine project goals, objectives, and technical requirements; develop performance indicators and relevant quantifiable criteria. Monitor and report on the performance of Compliance teams and initiatives by overseeing programs, dashboards, and advanced reporting.
Present findings of analyses to various staff levels including executive team, leadership team and staff levels. Present results in formats that are easy to understand and appropriate to the audience.
Install, implement, modify, and upgrade software and applications. Completes mass changes and imports as needed for Compliance and IEHP projects and teams.
Test, debug, and troubleshoot new and existing applications to resolve issues and/or implement enhancements.
Evaluate report requests to determine requestor's needs and objectives, identifying correct methodology for extracting data including data sources and criteria, and ensuring the delivered report is accurate, timely, and formatted appropriately.
Manage assigned projects and effectively communicating with project team to ensure project deliverables and deadlines are met. Effective communication with the Compliance leadership team is critical if any project deadlines are in jeopardy of not being met, well in advance.
Document and ensure assigned project / technical staff document all analysis / reporting projects following established protocols, ensuring replication of results by an independent reviewer.
Point of contact between IEHP and system vendors and internal partners; works closely with vendor and internal IEHP teams on system upgrades and modifications.
Establish and maintain effective working relationships with others throughout the organization.
Any other duties as required ensuring Health Plan operations are successful.

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.

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

Education & Experience
Minimum of six (6) years of experience designing, developing, and implementing systems and applications.

Experience in managing complex projects and programs utilizing systems, data, workplans, project management tools, developing and managing report and monitoring requirements, comfortable with external and leadership facing presentations, and analytical capabilities.

Experience with systems configuration and implementation of Governance, Risk, and Compliance (GRC) software and Managed Care Compliance Programs.
Bachelor's degree in a related field from an accredited institution required.
Key Qualifications

Advanced understanding of systems and processes of the Compliance department and organizational processes, Compliance Program requirements, and healthcare industry, specifically managed care organizations.

Advanced understanding of software configuration and implementation.
Exceptional computer skills and proficiency with GRC systems.
Excellent analytical, problem solving, and statistical analysis skills.
Demonstrated Leadership skills.
Robust organizational skills.
Ability to standardize processes, develop flows and operating procedures.
Project management skills.
Must have excellent written and verbal communication skills.

Expert level experience in Microsoft Office applications which includes, but is not limited to, Excel, Power BI, Word, PowerPoint, Outlook, and Visio.

Proven ability to:
Build trust with internal and external partners with strong rapport.
Establish and maintain effective working relationships across departments.
Coach and mentor others.
Possess strong multitasking capabilities.
Communicate effectively and succinctly with executive level staff.
Be extremely organized, with consistent preparation and follow through.
Be self-motivated.
Be extremely independent and self-managed.

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

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