Analyst II – Regulatory Affairs

IEHP

. Serve as the Plan’s internal subject matter expert by interpreting and applying contract, legislative, and regulatory requirements affecting multiple departments .

Posted 11/2/2026full-timeRancho Cucamonga • California • United StatesJuniorMid-Level💰 $71,573 - $93,038 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in interpreting and applying regulatory requirements within managed care, ensuring compliance with CMS, DHCS, DMHC, and Covered California. Proficient in developing policies and procedures while effectively communicating with internal departments and regulatory agencies.

Highest-signal resume keywords

Regulatory ComplianceManaged Care ExperiencePolicy DevelopmentInterpersonal CommunicationData Analysis

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Regulatory Requirements InterpretationCompliance Risk IdentificationData ValidationPolicy and Procedure DevelopmentResearch and Analysis1352(a) Amendments PreparationEFiling RequirementsKnowledge of Knox-Keene ActExperience with Medicare and Medi-CalManaged Care Principles

Soft Skills

Strong Interpersonal SkillsEffective CommunicationOrganizational SkillsAttention to DetailTeam Collaboration

Tools & Technologies

Microsoft Office SuiteWordExcelPowerPointOutlookAccess

Certifications & Qualifications

Bachelor's DegreeValid California Driver’s License

Industry Keywords

Covered CaliforniaMedicaid Managed Care PlansMedicare AdvantageSpecial Needs PlansMedicare-Medicaid PlansTitle 19Title 22Title 28Title 42CA Health and Safety Code

About the role

Key responsibilities & impact

Serve as the Plan’s internal subject matter expert by interpreting and applying contract, legislative, and regulatory requirements affecting multiple departments
Communicate new and revised laws and regulatory guidance, interpret and summarize requirements, disseminate requirements, and analyze responses
Obtain an understanding of the various systems and data sources utilized by the Plan
Identify compliance risks, issues, and barriers and recommend process or operational improvements
Ensure the Plan’s lines of business comply with CMS, DHCS, DMHC, Covered California, and other applicable regulatory requirements
Develop recommendations for appropriate compliance actions
Review and analyze compliance issues and inquiries and conduct research to provide accurate responses and recommendations
Advise and collaborate with internal departments on adherence to guidance and recommendations
Develop and recommend policies, procedures, standard operating procedures, and desk-top procedures where gaps, issues, or risks are identified
Coordinate reporting and submission requirements to CMS, DHCS, DMHC, Covered California, and other regulatory agencies
Receive, research, coordinate, respond to, and track inquiries and submissions
Validate data comprehensively before report submission
Assist internal departments with operational decisions related to reporting compliance
Analyze and interpret the Knox-Keene Act and identify eFiling and submission requirements
Prepare 1352(a) Amendments and Material Modifications for DMHC submission
Coordinate and respond to subsequent Comment Letters and amendments
Report potential risks, non-compliance, or alleged violations to the Director of Compliance
Assist in preparing the Plan for regulatory audits
Support compliance program components including Privacy, Data Security, Code of Business Conduct and Ethics, and Fraud Waste & Abuse
Participate in committees and work groups and develop data-based reports and presentations
Identify Compliance Department improvement areas and participate in performance improvement initiatives
Develop external and internal policies and procedures

Requirements

What you’ll need

Two (2) years of experience with managed care or other relevant industry experience
Experience in health care, health plans, Covered California, Medicaid Managed Care Plans (MCPs), Medicare Advantage, Medicare Part D, Special Needs Plans (SNPs), and/or Medicare-Medicaid Plans (MMPs)/Cal MediConnect
Experience interacting with regulatory agencies
Knowledge of and experience with state and Federal regulatory and other requirements and practices related to Covered California, Medicare and Medi-Cal (Medicaid), Title 19 (USC)/Title 29 (USC and CCR), Title 22 (CCR), Title 28 (CCR), Title 42 (USC and CFR), CA Welfare and Institutions Code, and CA Health and Safety Code
Bachelor's degree from an accredited institution required
Must have a valid California Driver’s license and valid automobile insurance
Must qualify and maintain driving record to drive company vehicles based on IEHP insurance standards of no more than three (3) points
Knowledge of Principles and practices of managed care
Strong interpersonal and presentation skills to communicate with internal departments and external agencies
Clearly and effectively convey project objectives
Strong organizational skills and attention to detail
Effective communication skills; verbal and written
Microsoft Office programs including, but not limited to, Word, Excel, PowerPoint, Outlook, and Access
Ability to apply knowledge and address situations appropriately without extensive guidance
Demonstrated ability to establish relationships of trust and respect with Team Members at all levels
Ability to manage multiple projects with competing deadlines and changing priorities
Ability to work independently and collaboratively within a team environment
Minimal travel within California
Minimal physical activity; may include standing and repetitive motion

Benefits

Comp & perks

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