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Analyst II - Grievance & Appeals
Inland Empire Health Plan - Rancho Cucamonga, CA
posted 2 months ago
About the position
The Analyst II - Grievance & Appeals position at Inland Empire Health Plan (IEHP) is responsible for performing complex analytical work in support of healthcare data analysis and decision-making. This role involves managing Grievance & Appeal data collection, conducting statistical analyses, and providing operational support to ensure compliance with regulatory standards. The incumbent will collaborate with various departments to enhance reporting accuracy and support strategic initiatives, all while exercising independent judgment in analytical techniques and recommendations.
Responsibilities
- Plan and organize complex studies related to departmental activities.
- Determine analytical techniques and information-gathering processes for data analysis.
- Analyze alternatives and make recommendations regarding organizational planning.
- Partner in the development and implementation of departmental goals and objectives.
- Collaborate with team members to coordinate and monitor assigned projects and reports.
- Track and analyze regulation changes and prepare documentation for audits.
- Compile, analyze, and prepare various departmental reports including daily, monthly, and quarterly reports.
- Analyze report requests to determine user needs and ensure accurate reporting.
- Document all reporting projects and ensure updates to department processes are completed.
- Troubleshoot reporting issues and incorrect data results.
- Adhere to regulatory requirements related to the business unit.
- Provide business support to database users and liaise with the IT department.
- Maintain knowledge of data sources for regulatory reporting and IEHP operations.
- Support and participate in LEAN initiatives and operational projects.
- Engage in projects that promote team member excitement and commitment to the organization.
- Conduct special projects and studies related to departmental functions.
Requirements
- Three or more years of experience in report writing and analysis.
- Extensive use and understanding of MS Access, Excel, Visio, Word, and PowerPoint.
- Bachelor's degree in health, business, or a related field from an accredited institution required.
- Master's degree from an accredited institution preferred.
- Experience in the healthcare field and/or Grievance & Appeal Health Plan experience preferred.
- Knowledge in report writing from data warehouse or specific report writing tools.
- Understanding of research and data analysis, with the ability to draw actionable insights from raw data.
- Knowledge of managed care principles and experience in related organizations.
- Excellent interpersonal and communication skills, both verbal and written.
- Strong data collection and systemization abilities.
- Ability to handle multiple projects and strong problem-solving capability.
- High attention to detail and accuracy.
Nice-to-haves
- Experience in healthcare data analysis and reporting.
- Familiarity with NCQA standards and regulatory compliance.
Benefits
- 457(b) retirement plan
- Disability insurance
- Health insurance
- On-site gym
- Dental insurance
- Flexible spending account
- Vision insurance
- Opportunities for advancement
- Life insurance
