Accounts Receivable Analyst
GLORY
Analyst II – Policy and Regulatory Operations
IEHP
full-time
Posted on:
Origin: • 🇺🇸 United States • California
Visit company websiteSalary
💰 $80,059 - $106,059 per year
Job Level
Mid-LevelSenior
About the role
- Plan and manage cross ‐ functional projects supporting regulatory compliance, system enhancement, process development, and improvement across Health Services, Quality Systems, Provider Services, and Member Services
- Develop and define project scope, goals, and deliverables; create, monitor, and maintain detailed project plans; manage changes to scope, schedule, and deliverables
- Communicate potential risks; ensure relationships between project stakeholders and resources; report and escalate project status and barriers to management; create and maintain comprehensive project documentation
- Review, update and manage internal and Provider policies; support management and publication of IEHP Provider Manual of Policies and Procedures, EDI Manual and internal department manuals
- Research, review and cite regulatory and accreditation requirements, plan policies, and other relevant sources; identify compliance and/or operational risks and impacts of policy changes
- Facilitate timely assessments of current policies against new regulations to identify compliance gaps and action plans
- Identify, gather, develop and bookmark evidence and narratives for regulatory and audit-related submissions
- Facilitate cross-functional implementation projects for compliance; perform requirements interpretation, gap analysis, resource planning, risk identification, implementation, and compliance monitoring
- Support system enhancement and process development requests by facilitating process flow documentation, standard work, business requirements, testing and validation
- Serve as primary analyst reviewer and support for assigned departments; prepare draft work output for QA review
- Perform a broad range of project management and research activities using analytical and critical thinking skills
- Support departments to make Lean business decisions by identifying opportunities for process improvements
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
- Must have a valid California Driver’s license
- 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
- 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
- While performing the duties of this job, the employee is occasionally required to stand; walk; sit; use hands to finger, handle, or feel objects, tools or controls; reach with hands and lift or move up to 25 pounds
- Specific vision abilities required by the job include close vision, distance vision, color vision, peripheral vision, depth perception and the ability to adjust focus
