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Under the direction of the Manager, Regulatory Affairs, the Analyst I - Regulatory Affairs (Policy & Communications) has a general knowledge of and performs key centralized regulatory activities of moderate difficulty for the Compliance Department.
$30.72 - $39.94 an hourFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Commitment to Quality: The IEHP Team is committed to incorporate IEHP’s Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation. Experience in health care, health plans, Medicaid Managed Care Plans (MCPs), Medicare Advantage, Medicare Part D, Special Needs Plans (SNPs), and/or Medicare-Medicaid Plans (MMPs)/Cal MediConnect.
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Strong experience in Guidewire Policy Center V10 Configuration, Integration, Rating Engine, product model configuration and GOSU Script development. Guidewire Certification in Policy Center Configuration and Integration V10 is required.
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Monitors the Plan’s lines of business adherence to contract(s) with the CMS, contract(s) with the DHCS, Knox-Keene license(s) with the DMHC, and any other applicable regulatory agencies. Knowledge of and experience with state and Federal regulatory and other requirements and practices related to Medicare and Medi-Cal (Medicaid), 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.
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