Member Data Analyst I

 

We have an opportunity to join the Alliance as a Member Data Analyst I in the Member Data Management Department. 

 

WHAT YOU'LL BE RESPONSIBLE FOR

Reporting to the Member Data Supervisor, this position: 

• Maintains the accuracy of member enrollment, Coordination of Benefits (COB) and Other Health Coverage (OHC) data, and Primary Care Provider (PCP) linkage data in Alliance information systems and those of its delegated sub-contractors to resolve the less complex eligibility, demographic, and coverage discrepancies that affect member access, utilization management, claims, and reporting.
• Researches, analyzes and responds to escalated internal and external customer questions [member data questions] and issues concerning Alliance member eligibility, demographics, and coverage.

 

ABOUT THE TEAM

 

We serve our members, providers, and partners with empathy through ongoing engagement, education, and support.

We keep busy in our communities, ensuring that Alliance members have both knowledge of and access to the benefits to which they are entitled. That also means actively expanding and assisting our provider network, from recruitment to timely payment.

In addition, to further advance the Alliance’s efficiency and effectiveness we analyze operational processes to identify areas of improvement.

 

WHAT YOU'LL NEED TO BE SUCCESSFUL

To read the full position description, and list of requirements click here. 

• Knowledge of:
• Working knowledge of research, analysis, and reporting methods.
• Working knowledge of government contracted regulated health plans, eligibility requirements and their respective automated eligibility verification systems.
• Working knowledge of the principles and practices of customer service.
• Some knowledge of data transmission, eligibility file formats, HIPAA, and system and data analysis.
• Some knowledge of Title 22 and 28 of the California Code of Regulations and Social Security Administration regulations relating to Medi-Cal eligibility.
• Ability to:
  • Ability to learn California Medi-Cal program, Medi-Cal eligibility, the Medi-Cal Eligibility Data System (MEDS-Lite) and its HIPAA compliant portal.
  • Ability to analyze less complex eligibility issues from identification to resolution.
  • Ability to collect, interpret, evaluate data, and prepare comprehensive reports.
  • Ability to conduct research, gather, and interpret information and data, identify issues of concern, make logical recommendations for action, and present findings in a clear and organized manner.
  • Ability to produce organized, accurate and detail-oriented work and maintain accurate records.
  • Ability to enter, proofread, verify, analyze and audit data.
• Education and Experience:
  • Bachelor’s degree in Business, Healthcare, Public Administration or a related field and a minimum of two years of experience in public assistance, health care or human services which involved working with Management Information Systems and spreadsheets and performing data entry.
  • Master’s degree may substitute for the required experience; or an equivalent combination of education and experience may be qualifying. 

 

OTHER INFORMATION

• We are in a hybrid work environment and we anticipate that the interview process will take place remotely via Microsoft Teams.
• While some staff may work full telecommuting schedules, attendance at quarterly company-wide events or department meetings will be expected.
• In-office or in-community presence may be required for some positions and is dependent on business need. Details about this can be reviewed during the interview process.

 

The full compensation range for this position is listed by location below. 

The actual compensation for this role will be determined by our compensation philosophy, analysis of the selected candidate's qualifications (direct or transferrable experience related to the position, education or training), as well as other factors (internal equity, market factors, and geographic location).

 

Typical areas in Zone 1: Bay Area, Sacramento, Los Angeles area, San Diego area

Typical areas in Zone 2: Fresno area, Bakersfield, Central Valley (with the exception of Sacramento), Eastern California, Eureka area

 

Zone 1 (Monterey, San Benito and Santa Cruz)$29.11—$46.58 USDZone 2 (Mariposa and Merced)$26.49—$42.39 USD

 

OUR BENEFITS 

Available for all regular Alliance employees working more than 30 hours per week. Some benefits are available on a pro-rated basis for part-time employees. These benefits are unavailable to temporary employees while on an assignment with the Alliance.

• Medical, Dental and Vision Plans
• Ample Paid Time Off 
• 12 Paid Holidays per year
• 401(a) Retirement Plan
• 457 Deferred Compensation Plan
• Robust Health and Wellness Program
• Onsite EV Charging Stations

ABOUT US

We are a group of over 500 dedicated employees, committed to our mission of providing accessible, quality health care that is guided by local innovation. We feel that our work is bigger than ourselves. We leave work each day knowing that we made a difference in the community around us. 

Join us at Central California Alliance for Health (the Alliance), where you will be part of a culture that is respectful, diverse, professional and fun, and where you are empowered to do your best work. As a regional non-profit health plan, we serve members in Mariposa, Merced, Monterey, San Benito and Santa Cruz counties. To learn more about us, take a look at our Fact Sheet.

The Alliance is an equal employment opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), sexual orientation, gender perception or identity, national origin, age, marital status, protected veteran status, or disability status. We are an E-Verify participating employer

At this time the Alliance does not provide any type of sponsorship. Applicants must be currently authorized to work in the United States on a full-time, ongoing basis without current or future needs for any type of employer supported or provided sponsorship.