Analyst II - Regulatory Affairs

About the role

Under the direction of the Manager, Regulatory Affairs, the Analyst II, Regulatory Affairs performs key centralized complex and difficult regulatory activities for the Compliance Department. This position ensures Plan operations, processes, procedures, and policies comply with regulatory agencies, including but not limited to, Covered California, the Centers for Medicare and Medicaid Services (CMS), the California Department of Health Care Services (DHCS), and the California Department of Managed Health Care (DMHC).

The IEHP Team is committed to incorporating IEHP’s Quality Program goals, including HEDIS, CAHPS, and NCQA Accreditation.

Responsibilities

• Ensure compliance with regulatory requirements from agencies such as Covered California, CMS, DHCS, and DMHC.
• Apply knowledge of state and federal regulatory requirements related to Covered California, Medicare, Medi-Cal (Medicaid), and other relevant codes and regulations.
• Interact with regulatory agencies and internal departments to convey project objectives and compliance standards.
• Manage multiple projects with competing deadlines and changing priorities.
• Work independently and collaboratively within a team environment.
• Minimal travel within California may be required.

Requirements

• Two (2) years of experience with managed care or other relevant industry experience.
• Experience in health care, health plans, Covered California, Medicaid Managed Care Plans (MCPs), Medicare Advantage, Medicare Part D, Special Needs Plans (SNPs), and/or Medicare-Medicaid Plans (MMPs)/Cal MediConnect.
• Knowledge of and experience with state and federal regulatory requirements, including Title 19 (USC)/Title 29 (USC and CCR), Title 22 (CCR), Title 28 (CCR), Title 42 (USC and CFR), CA Welfare and Institutions Code, and CA Health and Safety Code.
• Bachelor's degree from an accredited institution.

Qualifications

• Valid California Driver’s license and valid automobile insurance.
• Must qualify and maintain a driving record with no more than three (3) points based on IEHP insurance standards.
• Strong interpersonal and presentation skills to communicate with internal departments and external agencies.
• Effective verbal and written communication skills.
• Proficiency in Microsoft Office programs, including Word, Excel, PowerPoint, Outlook, and Access.
• Ability to apply knowledge and address situations appropriately without extensive guidance.
• Demonstrated ability to establish relationships of trust and respect with team members at all levels.
• Strong organizational skills and attention to detail.
• Minimal physical activity; may include standing and repetitive motion.

Benefits

• Competitive salary.
• State-of-the-art fitness center on-site.
• Medical insurance with dental and vision coverage.
• Life, short-term, and long-term disability options.
• Career advancement opportunities and professional development.
• Wellness programs promoting a healthy work-life balance.
• Flexible Spending Account for health care and childcare.
• CalPERS retirement.
• 457(b) option with a contribution match.
• Paid life insurance for employees.
• Pet care insurance.

Pay

Pay Range: $71,572.80 USD Annually - $93,038.40 USD Annually