Organization: Partnership HealthPlan of California
Location: Fairfield, CA
Date Job Posted: April 15, 2021
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Regulatory Reporting Analyst
Job ID 2021-1914 FLSA Status Exempt
To develop and implement long-term quantitative analysis strategies to meet NCQA and DHCS standards for reporting. To perform, and assist in the performance of, duties that ensure the accuracy, completeness and truthfulness of enterprise wide regulatory reporting including all data, information and documentation submitted to PHC’s governing agencies. Works collaboratively with all PHC department subject matter experts (SME) to implement new regulatory reporting requirements or templates and assist in troubleshooting regulatory reporting issues. To develop and implement strategies to meet NCQA standards for the oversight of delegate reporting. Supports the plan-wide Privacy and Fraud, Waste and Abuse (FWA) program by preparing trend analysis, forecasting reports and managing data collection in EthicsPoint.
Education and Experience
Bachelor’s degree in relevant field; two – three (2-3) years of experience in the health care field, managed care experience preferred; must have knowledge of regulatory related reporting requirements and Medi-Cal regulations; experience with data analytics and forecasting trends preferred; or equivalent combination of education and experience.
Special Skills, Licenses and Certifications
Highly proficient in applicable business software applications including PC usage, Microsoft Word, PowerPoint, Excel, Visio, SharePoint, typing speed 45 wpm. Valid California driver’s license and proof of current automobile insurance compliant with PHC policy are required to operate a vehicle and travel for company business.
Performance Based Competencies
Excellent oral and written communications skills. Excellent organization skills with ability to prioritize assignments, and maintain effective filing systems. Ability to work under minimal supervision and exercise excellent independent judgement. Diplomacy and tact in handling sensitive information regarding personnel affairs as required. Ability to interact with executives and vendors effectively, handling all assignments with efficiency. Must be able to work well under pressure, handle multiple tasks and meet deadlines under short turnaround times or tight timeframes.
Work Environment And Physical Demands
Ability to use a computer keyboard and other business machines. More than 50% of work time is spent in front of a computer monitor. When required, ability to move, carry, or lift objects of varying size, weighing up to 35 lbs.
Additional Preferred Skills:
All HealthPlan employees are expected to:
IMPORTANT DISCLAIMER NOTICE
The job duties, elements, responsibilities, skills, functions, experience, educational factors and the requirements and conditions listed in this job description are representative only and not exhaustive or definitive of the tasks that an employee may be required to perform. The employer reserves the right to revise this job description at any time and to require employees to perform other tasks as circumstances or conditions of its business, competitive considerations, or work environment change.