Job Summary
The Managed Care Contracting and Operations (MCCO) Department is responsible for the negotiation, implementation, administration, and operations of managed care agreements on behalf of Michigan Medicine, UMH-Sparrow, and UMH-West with all payers. MCCO also is responsible for Pre-Service Single Case Agreements, which are patient specific most often involving Out of State Payers. The Managed Care Payer Analyst will report to the Manager, Managed Care Operations and will assist in supporting the department with the day-to-day operations of all payer contracts for all three health systems, which includes: Joint Operating Committee (JOC) Meetings with Payers, Payer Oversight Committee Meetings, oversight of MCCO departmental mailbox, etc. The Managed Care Payer Analyst plays a vital role in ensuring transparent, effective communications, problem resolution, and relationship oversight exists between the MCCO Department and Payers.
Mission Statement
Michigan Medicine improves the health of patients, populations and communities through excellence in education, patient care, community service, research and technology development, and through leadership activities in Michigan, nationally and internationally. Our mission is guided by our Strategic Principles and has three critical components; patient care, education and research that together enhance our contribution to society.
Responsibilities*
- Support Manager, Managed Care Operations and Senior Director, Managed Care Contracting and Operations with payer Joint Operating Committee meetings (JOCs) across all three sites including Michigan Medicine, UMH-Sparrow, and UMH-West.
- Participate in Payer Oversight Committee Meetings which serve as gateway for internal departments to escalate payer issues via an SBAR process for potential approval of escalation to JOCs.
- Responsible for creation, dissemination, and maintenance of various payer meeting minutes, including but not limited to Joint Operating Committee meetings (JOCs).
- Create, distribute, and maintain various payer meeting agendas, including but not limited to Joint Operating Committee meetings (JOCs).
- Responsible for tracking and maintaining action items from various payer meetings, including but not limited to Joint Operating Committee meetings (JOCs).
- Support the Managed Care Contracting and Operations team with internal meetings, such as the Revenue Cycle Forum as it pertains to all three health systems.
- Support all areas within Michigan Medicine relating to payer activity including key departments that directly interact with payers including Revenue Cycle, Care Management, Pharmacy, and the professional medical groups.
- Collaborate with the Manager, Managed Care Operations to ensure accurate and timely dissemination of payer-related information.
- Assist in the oversight of the department shared email inbox by reviewing, investigating, and responding to various inquiries.
- Coordinate, edit, and assist with PowerPoint presentations, Word documents, and Excel spreadsheets, as needed.
- Collaborate with the Manager, Managed Care Operations to create and distribute periodic update reports for all functional/operational areas.
- Assist in improving operational processes related to managed care for all three sites including Michigan Medicine, UMH-Sparrow, and UMH-West
- Work in collaboration with team members within the MCCO Department.
Required Qualifications*
- Bachelor's degree in healthcare administration, business, or related field is preferred. Equivalent work experience is acceptable.
- Minimum of four (4) years of experience working in the healthcare industry or managed care organizations.
- Excellent written and verbal communication skills, with the ability to convey complex information clearly and effectively.
- Strong interpersonal skills and ability to build and maintain relationships with diverse stakeholders both internal and external.
- Proficiency in Microsoft Office Suite, including but not limited to Microsoft Excel, PowerPoint, and Word.
- Detail-oriented with strong organizational, time management, and decision-making skills.
- Ability to work both independently and as part of a team environment in a hybrid environment.
- Ability to manage multi-faceted tasks in a fast- paced work environment while maintaining the level of detail critical to managed care operations.
Desired Qualifications*
- Prefer to have experience with EPIC Electronical Medical Records System
- Project management experience
Modes of Work
Positions that are eligible for hybrid or mobile/remote work mode are at the discretion of the hiring department. Work agreements are reviewed annually at a minimum and are subject to change at any time, and for any reason, throughout the course of employment. Learn more about the work modes.
Additional Information
What You'll Do:
The Managed Care and Contracting Office is responsible for the negotiation, implementation, and administration of managed care agreements between Michigan Medicine, UM Health-Sparrow and UM Health-West and a wide range of healthcare delivery options. The Managed Care Payer Analyst will report to the Manager, Managed Care Operations and will support the department by assisting in the responsibilities of JOCs, Payer Oversight Committee Meetings and other operational duties as they relate to Payer relationships. Provide backup as necessary for other MCCO Department responsibilities.
Background Screening
Michigan Medicine conducts background screening and pre-employment drug testing on job candidates upon acceptance of a contingent job offer and may use a third party administrator to conduct background screenings. Background screenings are performed in compliance with the Fair Credit Report Act. Pre-employment drug testing applies to all selected candidates, including new or additional faculty and staff appointments, as well as transfers from other U-M campuses.
Application Deadline
Job openings are posted for a minimum of seven calendar days. The review and selection process may begin as early as the eighth day after posting. This opening may be removed from posting boards and filled anytime after the minimum posting period has ended.
U-M EEO/AA Statement
The University of Michigan is an equal opportunity/affirmative action employer.