Analyst II - Policy & Regulatory Operations
Inland Empire Health Plans
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! Under the Policy & Regulatory Operations Manager’s general supervision, the Analyst II – Policy & Regulatory Operations helps ensure Health Services, Quality Systems, Provider Services, and Member Services remain in compliance with Local, State, Federal, contractual and accreditation requirements and supports these departments’ operational strategies by completing compliance assessments, regulatory reviews and audit related submissions; managing cross-functional regulatory implementation, operational and system enhancement projects. The Analyst II - Policy & Regulatory Operations is responsible for Local, State, Federal, contractual and accreditation requirements interpretation, gap analysis, project scope development and initiation, resource planning, risk identification and project implementation, as well as timely comprehensive review and maintenance of internal and Provider policies. This includes gap analysis, project scope development and initiation, resource planning, risk identification, and project implementation, as well as timely and comprehensive review of internal and Provider policies. To do these effectively, the Analyst II – Policy & Regulatory Operations must have a clear understanding of IEHP business operations and the responsibilities of various departments in Health Services, Quality Systems, Provider Services, and Member Services, and demonstrated ability to effectively and consistently manage multiple projects and priorities concurrently. 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 Competitive salary State of the art fitness center on-site Medical Insurance with Dental and Vision Life, short-term, and long-term disability options Career advancement opportunities and professional development Wellness programs that promote a healthy work-life balance Flexible Spending Account – Health Care/Childcare CalPERS retirement 457(b) option with a contribution match Paid life insurance for employees Pet care insurance Education & Requirements At least three (3) years of experience providing analytical and/or project implementation support, including but not limited to regulatory review and analysis in a healthcare setting Bachelor’s degree from an accredited institution required Key Qualifications Working knowledge of project management software such as Workfront, MS Project or equivalent. Knowledge of managed care industry practices and standards including Local, Federal, State and/or accreditation standards, is preferred. Must have strong organizational skills. Must have strong critical thinking, research, verbal, and written communication skills. Demonstrated proficiency in Microsoft Office products: Word, Excel, Visio, and Power Point, sufficient for use in all aspects of an office environment. Must have the ability to manage multiple projects with competing deadlines and changing priorities. Must have the ability to work well in a team environment and build effective relationships with team members at all levels. Must be detail oriented. Exceptional follow-through to track all outstanding tasks and ensure these are completed timely. Start your journey towards a thriving future with IEHP and apply TODAY! #J-18808-Ljbffr Inland Empire Health Plans
$80.06k - $106.06k
...the human spirit” and to pivot from a “job” opportunity to an authentic experience! Under the Policy & Regulatory Operations Manager’s general supervision, the Analyst II - Policy & Regulatory Operations helps ensure Health Services, Quality Systems, Provider Services...OperationsPolicyRegulatoryTemporary workWork at officeLocal areaRemote workFlexible hours$26.52 - $36.47 per hour
...BSA related compliance issues to ensure regulatory requirements are met using various... ...Complies with and stays abreast of all policies and procedures, federal and state laws... ...Location This position is located at the operations center. Compensation Salary Range: $26...OperationsPolicyRegulatoryHourly pay$80.06k - $106.06k
...Supervisor of Product System Configuration, the Analyst II - Product System Configuration is... ...schedules and benefit structure, and regulatory billing guidelines required *... ...Extensive knowledge of general managed care operations required; delegated plan model preferred...OperationsRegulatoryTemporary workWork experience placementRemote workFlexible hours- Inland Empire Health Plan seeks an Analyst II - Policy & Regulatory Operations to ensure compliance across departments. You'll manage cross-functional projects and assess regulatory requirements while providing analytical support. This hybrid role emphasizes your project...OperationsPolicyRegulatory
$91.25k - $120.91k
...analytical techniques and processes, the IT Business Systems Analyst II provides guidance to IT and Business Departments, to... ...among stakeholders in order to understand the structure, policies, and operations of an organization, and to recommend solutions that enable...OperationsPolicyTemporary workWork experience placementRemote workFlexible hoursShift work- ...IT Business Systems Analyst II Rancho Cucamonga, CA | Hybrid Schedule | Full-Time... ...that directly supports member care and operational excellence. As an IT Business Systems... ...to understand organizational structure, policies, and operations Conduct facilitated...OperationsPolicyFull timeTemporary workWork experience placementWork at officeFlexible hours
- ...PRODUCTION OPERATOR II (3RD SHIFT 11:00pm-7:30am) Actively Hiring – Immediate Openings... ...duties necessary to meet Company, and or Regulatory Requirements / standards as prioritized... ...Employee follows all Food Fraud/food Defense Policies while on company property. Thorough...OperationsPolicyRegulatoryFull timeImmediate startShift workNight shift
$21.56 - $29.11 per hour
...alternative application process. EDD Analyst I Full Time Senior Office Operations Center, Rancho Cucamonga, CA, US 3... ...compliance issues to ensure regulatory requirements are met using various... ...Complies with and stays abreast of all policies and procedures, federal and state...OperationsPolicyRegulatoryHourly payFull timeWork at office$118.6k - $157.14k
...experience ! The Data Governance Analyst plays a key role in... ...to implement data standards, policies, and procedures that enhance... ...healthcare and managed care operations. # Monitor and improve data... ...e.g., HL7, ICD-10, CPT) and regulatory frameworks (e.g., HIPAA, CMS...OperationsPolicyRegulatoryTemporary workWork experience placementRemote workMonday to FridayFlexible hours$400 per month
...identifying, analyzing, and documenting operational risks, control gaps, and emerging... ...remediation. Ensure compliance with internal policies, regulatory requirements, and industry standards (e... ...g., OSFI, FSRA, IFRS 17, SOX, Solvency II), supported by testing and validation....OperationsPolicyRegulatoryWork at officeRemote workFlexible hours$80.06k - $106.06k
...instructions. Provide guidance to other Analysts. Commitment to Quality: The IEHP Team... ...Assist in the development and maintenance of policies and procedures related to job functions,... ...required Experience Health Plan Operations and Government Programs preferred Experience...OperationsPolicyTemporary workWork at officeRemote workMonday to FridayFlexible hoursShift work$80.06k - $106.06k
...Product Configuration Quality Analyst is responsible for ensuring... ..., business rules, and regulatory requirements. Ensure errors... ...standard metrics and business operational requirements to identify systematic... .... # Develop and maintain policies, procedures, and training...OperationsPolicyRegulatoryContract workTemporary workWork experience placementRemote workFlexible hoursAfternoon shift$26.52 - $36.47 per hour
...SUMMARY The Risk Modeling Analyst II plays a crucial role in supporting... ..., and stays abreast of, all policies and procedures, federal and... ...and auditors during regulatory examinations and internal audits... ...associate is regularly required to operate a computer keyboard, mouse,...PolicyRegulatoryHourly payFull timeWork at office$30.08 - $38.39 per hour
...Positions at the Police Dispatcher I/ii level may perform some of... ...safety of field units. Operates computer, telephone, radio... ...information regarding services, policies, and procedures; directs the... ..., state, and local laws, regulatory codes, ordinances, and procedures...OperationsPolicyRegulatoryHourly payPart timeFor contractorsWork at officeLocal areaTrial periodShift work- ...member interactions according to company policies and compliance standards. Utilize... ...Support compliance initiatives, audits, and regulatory reporting as required. Communicate... ...applicable laws and regulations. Escalate operational gaps or compliance concerns to...OperationsPolicyRegulatoryWork at office
$36.5 - $54.76 per hour
...Overview JOB SUMMARY The Respiratory Care Practitioner II (RCP II) is responsible for providing safe, effective, and... ...patients in accordance with physician orders, departmental policies, and regulatory standards. The RCP II functions as an essential member of the...PolicyRegulatoryDaily paid$31.61 per hour
...program. Be able to effectively operate equipment as required. Use... ...Health, Safety and Quality policies, including use of PPE.... ...necessary to meet Company, and or Regulatory Requirements / standards as... ...develop and train Mold Mechanic I, II & III and other production...OperationsPolicyRegulatoryFull timeApprenticeshipWork experience placementFlexible hoursShift work$73.77k - $103.28k
...awareness of and compliance with all policies, standards, and procedures,... ...minimize the impact to Bank operations and customers Collaborate... ...consists of Windows server, IIS, SQL administration.... ...or complaints from customers, regulatory agencies, or members of the business...OperationsPolicyRegulatoryTemporary workRemote work$28.52 - $42.78 per hour
Overview JOB SUMMARY The Coder II is primarily responsible for coding of outpatient... ...Guidelines, CPT Assistant, and organizational policies and procedures. The Coder II is... ...Delivery Observations accounts following all regulatory requirements. Strong knowledge of appropriate...PolicyRegulatoryDaily paid$21.56 - $29.11 per hour
...claims outside of the standard ACH return time frames. Essential Duties and Responsibilities Complies with and stays abreast of all policies and procedures, Nacha Rules, federal and state laws applicable to the job. Maintain time sensitive workflow related to ACH...PolicyHourly payWork at officeNight shift$21 per hour
...Warehouse II Pay Rate: $21/hour Shift Start time: 11AM The primary focus of the Warehouse... ...greater than approximately 50 pounds. Operate powered industrial vehicles (forklifts,... ...aligned with organizational goals. Policy & Procedures - The ability and skill to monitor...OperationsPolicyShift work- ...responsible for overseeing and driving the loan operations across multiple branches within the... ...alignment with corporate goals and regulatory compliance. This role involves... ...service quality and compliance with company policies and regulatory requirements. Lead, coach...OperationsPolicyRegulatory
- ...Title: Temporary Claims Specialist II - Provider Claims Assignment Length: Six... ...duties as required to ensure Health Plan operations are successful. Ensure the privacy and... ...Information) as outlined in IEHP's policies and procedures relating to HIPAA compliance...OperationsPolicyTemporary workWork at office
$91.25k - $120.91k
...the Quality Improvement (QI) Facilitator II works closely with front line leaders,... ...improvement programs. Prepare and present regulatory and committee, and other reports... ...duties as required to ensure Health Plan operations and department business needs are successful...OperationsRegulatoryTemporary workWork at officeRemote workFlexible hours$76.83k - $142.21k
...Property Claims Field Adjuster II If you're passionate about helping people restore their lives when the unexpected... ...Adjuster II will learn to apply knowledge of current Company policies, applicable regulatory standards, and procedures to investigate, evaluate and...PolicyRegulatoryLocal areaFlexible hours$72 - $85 per hour
...Quality Assurance, Behavioral Health, and Operations to strengthen clinical systems, reduce... ...Establish and oversee standardized policies and procedures for psychotropic medication... .... Ensure compliance with applicable regulatory requirements. Provide clear clinical...OperationsPolicyRegulatoryContract workPart timeReliefWork at officeWork from home$20 per hour
...federal regulations for the legal and safe operation of trucks and transportation vehicles... ...establish and uphold compliance protocols, policies, and procedures. Conduct regular... ...and address any issues or inquiries from regulatory authorities. Build and maintain strong...OperationsPolicyRegulatoryLocal areaRelocation package$150 per hour
...Life. The Quality Engineer II is primarily responsible for... ...Be Agile. Adhere to company policies and procedures. Problem Resolution... ...169, and or FDA QSR regulatory requirements. Computer literate... ...focus on our customers and on operational excellence. With nearly 6,000...PolicyRegulatoryLocal areaWorldwide- ...responsible for the overall clinical, operational, and administrative leadership of the Ambulatory... ...daily ASC operations, staffing, regulatory compliance, and clinical quality... ...Establish and enforce clinical protocols, policies, and evidence-based practices. Monitor...OperationsPolicyRegulatoryLocal area
$30.39k - $48.54k
...Support Specialist II Join Mercury Insurance as a Support Specialist II and play... ...service. In this role, you'll support claims operations through essential administrative... ...correspondence as well as explain Company policies and procedures and respond to routine inquiries...OperationsPolicyWork at officeLocal areaRemote workWork from home
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