Hospital Systems Analyst I - Hospital Relations (Hybrid Work Schedule)

Date: Jan 3, 2023

Location: Rancho Cucamonga, CA, US

Company: Inland Empire Health Plans

Job Requisition ID: 8563 

 

Position Summary/Position

 

Under close supervision, the Hospital Systems Analyst I - Hospital Relations (HSA I – Hospital Relations) provides assistance in departmental efforts to utilize clinical analytics to make health/quality management recommendations, as well as assist implementation of quality improvement activities based on those analytics that support IEHP compliance standards, strategic goals, and initiatives. Key activities include producing standard reports, ad hoc requests and supporting the development, preparation and presentation of quality studies, analyses and reports focused on hospital and ancillary provider performance. The Hospital Systems Analyst I - Hospital Relations completes assigned reporting projects to ensure that data and analysis requests are timely and accurate while presented in a way that meets the needs of the department. The Hospital Systems Analyst I - Hospital Relations assists in modeling healthcare related problems, discovering insights and identifying opportunities through the use of statistical, algorithmic, data mining, analysis and data visualization techniques. In addition to advanced analytical skills, the Hospital Systems Analyst I - Hospital Relations will display proficiency at integrating and preparing varied datasets, architecting analytical databases and visualization environments, and communicating results that are compliant with IEHP business rules and reporting requirements. Completes project deliverables that support key regulatory activities including study development, data collection, data analysis, policy interpretation, policy creation and updates. With experience, completes more diversified and complex assignments under general supervision.

Major Functions (Duties and Responsibilities)

 

1. Support the development, preparation and presentation of reports and analyses to advance IEHP’s Hospital Relations quality improvement programs utilizing available analytical tools and quality improvement methods.
2. In support of quality standards, strategic goals, and initiatives for hospitals, assists in the development of key studies and reports, data review, design and selection of performance metrics while working closely with department Team Members.  These activities include gaining working knowledge and understanding of quality compliance standards, internal and external healthcare/hospital and business operations, available data sources and systems, and appropriate data analysis criteria.
3. Develop timely and accurate data mining techniques to apply to new or existing standardized and ad-hoc reports that ensure consistent conclusions to data analysis.
4. Serve as supporting Analyst in the analysis, interpretation, and translation of complex data, issues, trends, and action plans as it relates to program development, quality studies (e.g., effectiveness studies, satisfaction studies) and department priorities.  Responsibilities include assisting with requirements gathering, data requests, analysis, interpretation, reasonability checks, and report format development.  As directed, will collaborate with internal and external partners on methodology to ensure requirements and analysis standards are met.
5. Assist with accurate and timely delivery of key studies and reports to meet compliance requirements . Responsible for assigned projects and effectively communicating with the team members and the Hospital Relations leadership team if any project deadlines or other deliverables are at risk.
6. Provide support to the department in ensuring continuous evaluation of trends related to quality measures, clinical and operational program performance. Participates in performance improvement efforts, as directed.
7. Assist in the development of reports, analyses, and other materials for Joint Operations Meetings (JOM) between the Health Plan and hospitals, other providers, or external stakeholders. 
8. Assist in the development of training materials, communications, and presentations for various levels of management depending on audience and deliverables.
9. Responsible for maintaining updated knowledge of IEHP business operations for performance and quality improvement studies, action plans and programs.  
10. Maintain knowledge of current NCQA Health Plan Accreditation Standards and the ability to interpret NCQA communications and changes.  Develop knowledge base on quality measures and relevant metrics that may be utilized to develop, track, and evaluate new and existing programs. 
11. With minimal supervision, effectively understand data results from various program designs and organize cohesive summaries in presentation formats presented to various audiences including internal and external Committees and stakeholders, the Governing Board, other member, and provider communication methods.
12. Assist in maintaining the Hospital Relations department policies including annual reviews and updates. Ensure policies are accurate and in accordance with applicable regulatory requirements.
13. Demonstrate understanding of department relationships and external partnerships to support Hospital Relations’ daily operations.
14. Demonstrate a commitment to support IEHP’s efforts to become a 5-Star Health Plan and incorporate LEAN principles into daily work.

Major Functions (Duties and Responsibilities) Cont

Supervisory Responsibilities

Leading: Self

Experience Qualifications

 

Two (2) or more years of experience in report writing, including extensive use and understanding of MS Access, Excel, Visio, Word and Powerpoint. Demonstrated experience and working knowledge of data systems, large data sets, creating queries, and developing reports for end users.   

Preferred Experience

 

Experience with electronic medical records, documentation, reporting/analysis in the healthcare field preferred.

Education Qualifications

 

Bachelor’s degree in Mathematics, Statistics, Computer Science, Business, Healthcare or related field from an accredited institution required from an accredited institution required.

Preferred Education

 

Master’s degree from an accredited institution preferred.  

Professional Certification

Professional Licenses

Drivers License Required

Yes, must have a valid California Driver's License.

Knowledge Requirement

 

Knowledge of Microsoft Suite is essential. Working knowledge of medical terminology and knowledge of managed care, claims payment processes and insurance terminology preferred. General knowledge of concepts, practices, and procedures within a healthcare setting preferred. Well-versed in relational database structures and database design. Demonstrate understanding of department relationships and external partnerships to support Hospital Relations’ daily operations.

Skills Requirement

 

Analytical skills with emphasis on healthcare services, regulatory interpretations and problem solving.  Ability to research, analyze data and make sound recommendations. Strong verbal and written communication skills. Strong data analysis, data presentation, spread sheet and database capabilities.

Abilities Requirement

 

Strong attention to detail.

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.

Working Conditions

 

Word processing and data entry involving computer keyboard and screens.

Work Model Location

Hybrid

Physical Requirements

Keyboarding: Traditional - FREQUENTLY
Keyboarding: 10-Key - FREQUENTLY
Keyboarding: Touch-Screen - FREQUENTLY
Regular contacts: co-workers, supervisor - FREQUENTLY
Near Visual Acuity - FREQUENTLY
Communicate: Information/ideas verbally - FREQUENTLY
Hearing: One-on-One - FREQUENTLY
Sitting - CONSTANTLY
Lighting - CONSTANTLY
Indoors - FREQUENTLY
Memory - FREQUENTLY
Regular and reliable attendance - CONSTANTLY
Hearing: In a group - FREQUENTLY
Hearing: Conference Speakers/Video Calls/Radio Calls - FREQUENTLY
Perform complex and varied tasks - FREQUENTLY
Develop and maintain positive work relationships - CONSTANTLY
Adaptability: rate of change in work tasks - FREQUENTLY
Rapid Pace of work - CONSTANTLY
Pace of work with faster/slower work periods - FREQUENTLY
Understand and follow direction - CONSTANTLY

A reasonable salary expectation is between $79,809.60 and $101,774.40, 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