Position Summary:

Under the supervision of the Health Systems Development Deputy Director, the Program Analyst is responsible for serving as CRIHB’s in-house expert on reimbursement-based programs and participates in the development of other programs as directed by CRIHB Leadership. This position also provides comprehensive training and technical assistance to Tribal Health Programs participating in such programs. This position works closely with state-wide reimbursement programs to provide evaluation and monitoring support.

Essential Functions:

1.Conducts outreach, recruitment, training, and technical assistance of tribes and/or Health Programs throughout California participating in CRIHB administered reimbursement programs.

2.Reviews and processes claims by working in conjunction with Third Party Administrators, the State of California and staff at participating Tribal Health Programs.

3.Establishes and maintains relationships with sites participating in reimbursement programs

4.Makes recommendations for process improvements for reimbursement programs

5.Assists CRIHB leadership in the development of new reimbursement-based programs

6.Provides written reports on program status to management and Board of Directors.

7.Conducts ongoing monitoring and evaluation of reimbursement programs.

8.Supports the program site coordinators in processing claims for reimbursement by conducting the documentation review process.

9.Conducts trainings for sites participating in reimbursement programs.

10.Sthe program site coordinators in developing invoices as necessary.

11.Develops and implements tools to facilitate organization of reimbursement programs.

12.Prepares reimbursement programs for audits and ensures documentation is in place and state-defined processes are followed.

13.Coordinate with external technical support team and internal staff to ensure all system needs are addressed.

14.Any additional duties as assigned.

Additional Responsibilities

1. Maintain a valid, unrestricted California Driver’s license and ability to be insurable under CRIHB’s automobile insurance. If employee has a valid license from another state, he/she must obtain a CA license within 2 months of hiring date.

2. Position requires overnight travel within CRIHB’s service area.

3. Requires ability to drive up to 7 hours a day.

Qualifications:

1.Bachelor’s degree in Accounting or a related field with three years of relevant work experience;

2.Must have demonstrated financial background

3.Experience in Medi-Cal reimbursement program preferred

4.Must have strong written and verbal communication skills.

5.Proficiency in Excel is required.

6.Advanced computer skills including Microsoft Office; especially Word, Excel, and PowerPoint.

7.Experience hosting online meetings and trainings.

8.Ability to research and resolve issues.

9.Excellent organizational skills and attention to detail.

10.Experience in Purchased/Referred Care preferred

11.Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA).

12.Ability to establish and maintain positive and effective work relationships with coworkers, clients, members, providers and customer.

This position requires an awareness and keen appreciation of American Indian traditions, customs and socioeconomic needs and the ability at all times to meet and deal effectively in contacts with Indian organizations which requires tact, courtesy, discretion, resourcefulness, and good judgment in handling functions of a sensitive nature.

Preference in hiring is given to qualified American Indians in accordance with the Indian Preference Act (Title 25, U.S. Code, Sections 472 and 473). Applicants claiming Indian Preference must submit Indian verification, certified by Tribe of affiliation or other acceptable documentation of Indian heritage.

Job Type: Full-time

Pay: $72,319.00 per year

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Professional development assistance
• Retirement plan
• Tuition reimbursement
• Vision insurance

Compensation package:

• Yearly pay

Experience level:

• 3 years

Schedule:

• Day shift
• Monday to Friday

Application Question(s):

• Are you claiming Indian Preference?

Education:

• Bachelor's (Preferred)

Experience:

• Accounting or a related field: 3 years (Required)
• Medi-Cal Reimbursements: 1 year (Required)
• Microsoft Excel: 1 year (Required)

Ability to Relocate:

• Roseville, CA 95661: Relocate before starting work (Required)

Work Location: In person