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Managed Care Payer/Operations Analyst

Job Description

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*

Required Qualifications*

Desired Qualifications*

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.

*Please mention you saw this ad on Over50InCareers.*

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