IEHP Eligibility Reconciliation Analyst

*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 deadlinesJob Type: Full-timePay: $63,897.60 - $83,075.20 per yearBenefits:* 401(k)* Dental insurance* Flexible spending account* Health insurance* Paid time off* Tuition reimbursement* Vision insuranceSchedule:* Day shift* Monday to FridayWork Location: Hybrid remote in Rancho Cucamonga, CA 91730

Created: 2025-06-11