IEHP · 3 days ago
Analyst II - Product System Configuration
Rancho Cucamonga, CA
Full-time
Hybrid
Mid Level
$80K/yr - $106K/yr
4+ years expIEHP is dedicated to healing and inspiring the human spirit, and they are seeking an Analyst II – Product System Configuration. This role involves managing complex system configurations and interpreting guidelines related to benefits and contracts, while also serving as a subject matter expert and facilitating communication across departments.
Health CareHealth DiagnosticsHospital
Responsibilities
Managing the more complex system configurations within the Business System
Accurate interpretation of state, federal, and contractual guidelines related to benefits, fee schedules, contracts, division of financial responsibility (DOFR), codification of services, and business requirements and translating them into configurable parameters within the Business Systems
Developing and maintaining comprehensive documentation of business and technical specification requirements utilizing best practice configuration guidelines developed by the Application Architects within the unit
Facilitating communication and formally reporting findings to various department heads and staff in a manner that is appropriate to the skill level and technical expertise of the audience
Training and helping educate other team members within the unit as necessary
Qualification
Required
Four (4) years of experience with the development and remediation of moderately complex system configurations, including capitated provider agreement configurations
Bachelor's degree from an accredited institution required
+ 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 general healthcare experience plus two (2) years of configuration experience is required
Knowledge of Medicare and Medi-Cal fee schedules and benefit structure, and regulatory billing guidelines required
Extensive knowledge of general managed care operations required; delegated plan model preferred
Exceptional problem solving and critical thinking skills
Strong presentation and written communication skills
Ability to work independently and solve complex problems with little to no assistance
Ability to effectively manage multiple competing priorities
Preferred
Experience in major managed care system migration/implementation preferred
Knowledge of CMS, DHCS, DMHC, NCQA rules and regulations preferred
Extensive knowledge of CPT, HCPCS, Revenue, ICD10 coding rules and guidelines preferred
Basic knowledge of relational database structure
Advanced knowledge of Product System algorithms and processes preferred
Familiar with basic medical product processing preferred
Skilled in the use of Microsoft Excel and Access preferred
Benefits
Telecommute schedule
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
Company
IEHP
With a mission to heal and inspire the human spirit, Inland Empire Health Plan (IEHP) is one of the top 10 largest Medicaid health plans, the largest not-for-profit Medicare-Medicaid public health plan in the country, and for the fourth year in a row, certified as A Great Place To Work®.
1001-5000 employees
Funding
Current Stage
Late StageTotal Funding
$32.38M2021-02-04Grant· $32.38M
Leadership Team
Susie White
Chief Operating Officer
Katherine A. Kang
Vice President, HR Strategic Initiatives and Business Partners
Recent News
PR Newswire
2025-11-11
2025-09-19
2025-09-18
Company data provided by crunchbase