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Iehp Jobs in Riverside, CA (NOW HIRING)

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Iehp information

What is an IEHP?

An IEHP job refers to a position with Inland Empire Health Plan (IEHP), a nonprofit health organization that provides Medi-Cal and Medicare health services in California. IEHP offers various roles in healthcare administration, customer service, case management, and IT to support its mission of delivering quality healthcare to members. Employees at IEHP work in a collaborative environment focused on improving healthcare access and outcomes for underserved communities.

What are the key skills and qualifications needed to thrive in the IEHP position, and why are they important?

To thrive in a role at IEHP (Inland Empire Health Plan), candidates typically need a background in healthcare administration, case management, or related health services fields, often with relevant certifications such as RN, LVN, LCSW, or a degree in public health. Familiarity with health plan software, managed care systems, and regulatory compliance tools is important. Strong soft skills like cultural competency, analytical problem-solving, and effective communication help professionals collaborate with diverse members and healthcare providers. These competencies ensure high-quality, coordinated care and support for plan members, contributing to efficient health outcomes.

What types of advancement opportunities are available for employees at IEHP?

IEHP fosters a culture of professional growth, offering employees numerous opportunities for advancement within the organization. Team members are encouraged to take part in continuous education programs, skills training, and leadership development initiatives. Depending on your role and performance, you may be able to progress into supervisory, management, or specialized clinical positions over time. Additionally, IEHP often promotes from within and places strong emphasis on supporting career growth for dedicated team members.

What are the most commonly searched types of Iehp jobs in Riverside, CA?

The most popular types of Iehp jobs in Riverside, CA are:

What are popular job titles related to Iehp jobs in Riverside, CA?

For Iehp jobs in Riverside, CA, the most frequently searched job titles are:

What job categories do people searching Iehp jobs in Riverside, CA look for?

The top searched job categories for Iehp jobs in Riverside, CA are:

What cities near Riverside, CA are hiring for Iehp jobs?

Cities near Riverside, CA with the most Iehp job openings:

Iehp jobs near you
Infographic showing various Iehp job openings in Riverside, CA as of August 2026, with employment types broken down into 100% Full Time. Highlights an 85% Physical, 11% Hybrid, and 4% Remote job distribution.

Engineer III - EDI

Inland Empire Health Plan

Rancho Cucamonga, CA • On-site

$118K - $157K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 15 days ago

Inland Empire Health Plan rating

6.8

Company rating: 6.8 out of 10

Based on 5 frontline employees who took The Breakroom Quiz

268th of 311 rated insurance

Job description

Overview
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.
Additional Benefits
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

Key Responsibilities
  1. Present findings of analyses to various staff levels. Present results in formats that are easy to understand and appropriate to the audience.
  2. Provide recommendations for necessary changes in existing EDI processes.
  3. Monitor and Track quality and completeness of data submitted to CMS and DHCS.
  4. Analyze rejections and provide recommendations for remediation.
  5. Guiding team members on topics related to encounters submissions to IEHP's regulatory bodies, remediating submission errors.
  6. Communicate with Trading Partners/ CMS/DHCS on needed basis
  7. Create BRDs
  8. Clear understanding of IEHP business operations
  9. Responsible for managing assigned projects and effectively communicating project team to ensure project deliverables and deadlines are met.
  10. Document and ensure assigned project / technical staff document all analysis / reporting projects following established protocols, ensuring replication of results by an independent reviewer.
  11. Demonstrate a commitment to incorporate LEAN principles into daily work.
  12. Establish and maintain effective working relationships with others throughout the organization.
  13. Any other duties as required to ensure the Health Plan operations are successful.
  14. Ensure the privacy and security of PHI (Protected Health Information) as outlined in IEHP's policies and procedures relating to HIPAA compliance.

Qualifications
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!
Work Model Location
  • This position is on a hybrid work schedule. (Monday & Friday - remote, Tuesday - Thursday onsite in Rancho Cucamonga, CA.)
  • Position is eligible for Hybrid work location upon completing the necessary steps and receiving HR approval. All IEHP positions approved for telecommute or hybrid work locations may periodically be required to report to IEHP's main campus for mandatory in-person meetings or for other business needs as determined by IEHP leadership.

Pay Range
USD $118,601.60 - USD $157,144.00 /Yr.

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