EDUCATION & REQUIREMENTS

• Four (4) years of experience with the development and remediation of moderately complex system configurations, including capitated provider agreement configurations
• Experience in major managed care system migration/implementation preferred
• 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
• This experience is in addition to the minimum years listed in the Experience Requirements above

KEY QUALIFICATIONS

• Knowledge of Medicare and Medi-Cal fee schedules and benefit structure, and regulatory billing guidelines required
• Knowledge of CMS, DHCS, DMHC, NCQA rules and regulations preferred
• Extensive knowledge of CPT, HCPCS, Revenue, ICD10 coding rules and guidelines preferred
• Extensive knowledge of general managed care operations required; delegated plan model 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
• 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
• Position is eligible for telecommuting/remote work location upon completing the necessary steps and receiving HR approval
• All IEHP positions approved for telecommute or hybrid work locations may periodically be required to report to IEHP’s main campus for mandatory in-person meetings or for other business needs as determined by IEHP leadership
  Job Type: Full-time
  Pay: $80,059.20 - $106,059.20 per year

Benefits:

• Dental insurance
• Flexible spending account
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Parental leave
• Professional development assistance
• Retirement plan
• Tuition reimbursement

Work Location: Hybrid remote in Rancho Cucamonga, CA 9173

Please refer the Job description for details