This job listing is no longer available for applications. The position may have been filled or the posting period has ended.
Job Description
*Job Summary* Under the Manager, Business Systems Operations Support, the Eligibility Reconciliation Analyst will identify, research & resolve discrepancies between source data and IEHP eligibility data. The incumbent is responsible for identifying and resolving discrepancies in Member's demographic, enrollment, premium and eligibility data between federal and/or state data against IEHP's membership. The Reconciliation Analyst will perform a variety of duties related to membership reconciliation from various sources.
*Education & Requirements * * At least two (2) years of relevant experience: a minimum of one (1) year of experience demonstrating excellent organizational, time management, and facilitation skills required * Experience demonstrating initiative and self-direction with the ability to work well independently and in teams while serving as a Subject Matter Expert (SME) required * Also includes at least one year of eligibility research experience in a managed care setting required * Minimum of 1 year experience and knowledge of Covered California regulatory requirements and membership reconciliation preferred * Minimum of 1 year experience and knowledge of Medicare regulatory requirements preferred * Experience with Covered CA or other Exchange products preferred * Bachelor’s Degree in Business Administration, Health Care Administration, Computer Information Systems (CIS), Management Information Systems (MIS), or other related field from an accredited institution required * One (1) of the following scenarios will be accepted in lieu of a Bachelor’s degree: * In lieu of the required degree, a minimum of four (4) years of additional relevant work experience is required for this position: Two (2) years of Health Care or Managed Care Operations experience and a minimum of two (2) years of data reconciliation or experience working with Eligibility data is required * This experience is in addition to the minimum years listed in the Experience Requirements above
*Key Qualifications* * Experience and/or knowledge of the 834-file format system preferred * Requires excellent critical thinking, root cause analysis, and problem-solving skills as well as excellent written and verbal communication skills with the ability to communicate and present effectively in large forums to discuss complex information * Also requires a high level of attention to detail * Ability to work independently and solve complex problems with little to no assistance * Effectively manage multiple competing priorities and adhere to strict timelines * Ability to effectively manage multiple competing priorities * Ability to manage multiple projects of varying complexity, priority levels and deadlines
Job Type: Full-time
Pay: $63,897.60 - $83,075.20 per year
Benefits: * 401(k) * Dental insurance * Flexible spending account * Health insurance * Paid time off * Tuition reimbursement * Vision insurance Schedule: * Day shift * Monday to Friday
Work Location: Hybrid remote in Rancho Cucamonga, CA 91730