Engineer III - EDI
Rancho Cucamonga, California
What you can expect!
Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience!
Under the direction of the Encounters & EDI Leadership Team, the Engineer III is responsible for analysis of new DHCS/CMS requirements and providing recommendations for new rules implementation, submissions tracking, remediating submission errors, responding to regulatory changes, and monitoring encounter submissions to DHCS and CMS, and acceptance compliance. The Engineer III also is responsible for BRDs creation and communication with Trading Partners. The Engineer III must be able to work independently, often working directly with business users and IT groups to understand and document requirements. The Engineer III will work cross-functionally with department leaders to deliver actionable analyses / results.
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.
Perks
IEHP is not only committed to healing and inspiring the human spirit of our Members; we also aim to match our Team Members with the same energy by providing prime benefits and more.
- CalPERS retirement
- 457(b) option with a contribution match
- Generous paid time off- vacation, holidays, sick
- State of the art fitness center on-site
- Medical Insurance with Dental and Vision
- Paid life insurance for employees with additional options
- Short-term, and long-term disability options
- Pet care insurance
- Flexible Spending Account – Health Care/Childcare
- Wellness programs that promote a healthy work-life balance
- Career advancement opportunities and professional development
- Competitive salary with annual merit increase
- Team bonus opportunities
Education & Experience
- Six (6) years of relevant work experience
- Bachelor's degree from an accredited institution required
- Master's degree in Data Science, Informatics, Public Health, Epidemiology, or a related field from an accredited institution preferred
Key Qualifications
- In depth knowledge of Healthcare HIPAA requirements and CA State and CMS regulations and X12 formats
- Expertise in SQL, SSRS. Knowledge of EDIFECS or similar tools is a plus
- Extensive knowledge of Microsoft Office (Excel, Word, Visio, and Power Point) is essential
- Working knowledge of medical terminology, knowledge of managed care, eligibility and/or pharmacy processes, and insurance terminology preferred
- Must be able to handle multiple projects, prioritize to meet deadlines, and develop effective working relationships
- Strong problem-solving capability, excellent interpersonal, and communication skills
- Ability to explain complex data analyses and findings in a way that is easy to understand and appropriate to the audience. Strong attention to detail
Start your journey towards a thriving future with IEHP and apply TODAY!
Pay Range
- $118,601.60 USD Annually - $157,144.00 USD Annually
Working at IEHP is always about helping our members and helping our team members and for me to address anything that they need from me. It’s something that I take pride in every day.
Maynard Mungcal Learning & Development Analyst 2
I love working for IEHP. I really think they not only care about their members, but they also care about their employees … I've been here for eight years, and I just love it!
Mayra Gomez Senior Pharmacy Medication Management Specialist
It’s not just clocking in and clocking out, but being thoughtful and being proud and being an advocate for the work that we do … When people ask me how my day was or how my work is, it’s something that I’m profoundly proud of because I know that I’m making a difference.
Phillip Lo Director of Business Continuity
