Health Plan Analyst Jobs in Riverside, CA (NOW HIRING)

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!

The Manager, Transformation & Analytics is an experienced analytics and actuarial-informed leader responsible for driving enterprise-wise analytics initiatives to guide strategic and transformative decision-making. This role blends advanced analytics with foundational actuarial methodologies to enhance forecasting accuracy, financial modeling, and operational performance insights to enable clarity, foresight and decisive action leading to successful transformational objectives. The manager oversees a team of analysts and collaborates closely with IEHP’s actuarial leadership to ensure decision-support models reflect sound analytical principles. This position plays a critical role in aligning transformation analytics vision with the health plan's overall goals, which include adapting to California's complex and evolving managed care and regulatory environment to ensure competitive advantage. The Manager, Transformation & Analytics is technical, grounded in sound data analytical principles (i.e., Descriptive, Diagnostic, Predictive and Prescriptive), big picture oriented, can think strategically, and is comfortable presenting complex analytic information to executives.

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, but we also aim to match our team members with the same energy by providing prime benefits and more.

• Competitive salary
• State of the art fitness center on-site
• Medical Insurance with Dental and Vision
• Life, short-term, and long-term disability options
• Career advancement opportunities and professional development
• Wellness programs that promote a healthy work-life balance
• Flexible Spending Account – Health Care/Childcare
• CalPERS retirement
• 457(b) option with a contribution match
• Paid life insurance for employees
• Pet care insurance

1. Provide strategic support to the Chief Transformation Officer with transformation efforts by incorporating foundational actuarial techniques, including trend analysis, risk assessment, and development of actuarial assumptions to support forecasting, financial modeling and planning, budgeting, and strategic transformation initiatives. Provide evidence-based recommendations to execute strategic and transformation efforts.
2. Lead the integration of actuarial insights into decision-support models by analyzing financial performance against forecasts, conducting variance analyses, and providing insights to optimize financial outcomes in areas such as product performance, provider network analytics, and rate development.
3. Direct the analysis of large volumes of complex data to identify business trends, operational efficiencies, and opportunities for performance improvement.
4. Provide leadership oversight in the development of actuarial informed dashboards, models, and reports that communicate financial and risk based insights to executives and cross functional stakeholders.
5. Partner with department leaders across Actuarial, Finance, Operations, Health Services, and IT to align insights with departmental and organizational goals. Partner with department leaders to create presentations of analytical reports and dashboards for various stakeholders, departments, and divisions.
6. Lead, mentor, and develop analysts and reporting specialists that demonstrate competency and proficiency in their roles.
7. Manage analytics strategies projects from initiation defining project scope and stakeholders to completion, ensuring timely delivery and effective use of resources while supporting desired project outcomes.
8. Ensure analytics and reporting processes adhere to California's state and federal managed care regulations, which are particularly important for health plans serving government-sponsored programs such as Medi-Cal, D-SNP, Covered California, and similar programs in order to foster regulatory compliance.
9. Build strong relationships across the organization to break down silos and embed data-driven decision-making fostering cross-functional collaboration.
10. Utilize technology and systems such as business intelligence (BI) tools, data warehouses, and reporting applications to ensure robust and accurate insights.
11. Drive innovation through emerging technologies, including AI, machine learning, and advanced analytics to enhance organizational agility and insight generation.
12. Perform any other duties as required to ensure Health Plan operations and department business needs are successful.

Education & Requirements 

• Minimum of seven (7) years of demonstrated experience in a clinical/healthcare environment required
• A minimum of five (5) years of experience must be directly related to working with trend analysis, forecasting, data systems, and large data sets
• Proven background utilizing a strong blend of program management expertise and deep understanding of data analytics/visualization principles to drive cross-functional collaboration
• Demonstrated experience with at least one (1) major business insights (BI)/visualization tool (e.g., Tableau, Power BI, Looker, Qlik Sense, Superset)
• A minimum of three (3) years of experience in leading a technical team
• Experience across all lines of business including Medicaid, Medicare, and Commercial is preferred
• Experience in supporting actuarial deliverables preferred
• Bachelor’s degree from an accredited institution required
• Master’s degree from an accredited institution preferred
• PMP, Tableau/Power BI certifications, Lean Six Sigma, healthcare quality, or Associate of the Society of Actuaries (ASA)

Key Qualifications

• Comprehensive knowledge and deep understanding in the following areas:
  • Data visualization principles, best practices, and common pitfalls
  • Various data types, structures, and their appropriate visual representations
  • User experience (UX) design principles as they apply to data interfaces
  • Familiarity with data governance, data quality, and data security concepts
  • Basic project management methodologies
  • Basic SQL and data warehousing concepts
  • Foundational understanding of actuarial concepts such as trend development, risk adjustment, and forecasting
  • Familiarity with healthcare financial modeling or actuarial rate development principles.
  • Exposure to actuarial data types (membership projections, reserves, or similar data types) preferred.
• Strong analytical and critical thinking skills
• Demonstrated expertise with at least one (1) major BI/visualization tool (e.g., Tableau, Power BI, Looker, Qlik Sense, Superset)
• Proficient in all Microsoft Office applications, with an emphasis on Excel, PowerPoint and Visio
• Strong communication skills (verbal, written and listening) with ability to interact effectively
• Leadership skills
• Ability to interpret actuarial assumptions and incorporate them into financial and transformation models
• Ability to collaborate with credentialed actuaries on trend analysis
• Strong quantitative reasoning with familiarity in various analytical evaluation methods
• Proven ability to:
  • Lead a team of technical professionals
  • Successfully interpret business needs and leverage analytical tools to support data driven decision making
  • Perform complex tasks, prioritize multiple projects and work under pressure to meet deadlines in a fast-paced environment.
  • Work independently, exhibiting high attention to detail and takes initiative
  • Identify and resolve problems, think creatively, strategically, and analytically

Start your journey towards a thriving future with IEHP and apply TODAY!

This position is on a hybrid work schedule. (Mon & Fri - remote, Tues - Thurs onsite in Rancho Cucamonga, CA.)