Analyst I - Utilization Management (Hybrid Work Schedule)

Date: Jan 12, 2023

Location: Rancho Cucamonga, CA, US

Company: Inland Empire Health Plans

Job Requisition ID: 8616 


Position Summary/Position


Under the direction of the Utilization Management Leadership, the Utilization Management Analyst I is responsible for providing technical and analytical support to assist with the IEHP Direct Department, reporting activities and special projects. Responsibilities include developing, analyzing, maintaining, and updating Departmental reports. The Analyst I is responsible for managing assigned projects while providing technical based project support to the UM Department.

Major Functions (Duties and Responsibilities)


1. Support the UM Management Team in developing, preparing, and analyzing reports to support the strategic goals of the UM Department.
2. Responsible for determining requestor’s objective of report, identifying logic, documenting criteria and delivering report accurately, timely and appropriately formatted. 
3. Prepare ad hoc reports, charts, and graphs as requested and analyze rends and collaborate with specific units to improve data.
4. Create dashboards using a variety of data visualization tools
5. Obtain an understanding of the various systems and data sources utilized by the organization for reporting.
6. Assure quality and accuracy of reports by assessing report requests and results.
7. Apply independent critical thinking to analyst vast data sets to uncover insights, what’s working and what’s not.
8. Participate in brainstorming sessions with unit leaders.
9. Contribute to the overall departments reporting capabilities
10. Participate actively in maintaining LEAN mission control with use of visual management.
11. Effectively manage assigned projects and report the status of assigned tasks and/or related problems or issues to Management.
12. Maintain technical specifications of any developed reports and/or solutions.

Experience Qualifications


One (1) year of experience required in a managed care environment, including extensive use of MS Excel at an expert level and SQL with the ability to create complex spreadsheets. Experience required in generating reports and preparing charts and graphs.

Preferred Experience


Experience preferred in database manipulation, running queries, and linking tables. Experience preferred in basic project management, such as tracking progress and follow-up with others. Preferably familiar with Utilization Management activities to include CMS, NCQA and DHCS regulatory requirements.

Education Qualifications


Bachelor’s degree in related field from an accredited institution required.

In lieu of the required degree, a minimum of four (4) years of additional relevant work experience in a Health Care setting of which are at least two (2) years in Utilization Management is required for this position. This experience is in addition to the minimum years listed in the Experience Requirements above.

Skills Requirement


Data analysis, word processing, spread sheet and database capabilities. Extensive knowledge of Microsoft Access, Word and Excel essential. Strong organizational skills.

Abilities Requirement


Ability to present data in report formats that are easy to understand. Ability to manage multiple projects with competing deadlines and changing priorities. Ability to work independently with little direction. Attention to detail. Ability to work well in a team environment.

Commitment to Team Culture


The IEHP Team environment requires a Team Member to participate in the IEHP Team Culture. A Team Member demonstrates support of the Culture by developing professional and effective working relationships that include elements of respect and cooperation with Team Members, Members and associates outside of our organization.

Work Model Location


A reasonable salary expectation is between $61,422.40 and $78,312.00, based upon experience and internal equity.

Inland Empire Health Plan (IEHP) is the largest not-for-profit Medi-Cal and Medicare health plan in the Inland Empire. We are also one of the largest employers in the region, designated as “Great Place to Work.” With a provider network of more than 5,000 and a team of more than 3,000 employees, IEHP provides quality, accessible healthcare services to more than 1.5 million members. And our Mission, Vision, and Values help guide us in the development of innovative programs and the creation of an award-winning workplace. As the healthcare landscape is transformed, we’re ready to make a difference today and in the years to come. Join our Team and make a difference with us! IEHP offers a competitive salary and stellar benefit package with a value estimated at 35% of the annual salary, including medical, dental, vision, team bonus, and state pension plan.

Nearest Major Market: Riverside
Nearest Secondary Market: Los Angeles