Managed Care Contract Administrator, MPP - Remote

We are looking for a Contract Administrator to join us in leading our organization forward.

McLaren Health Care is one of Michigan's fastest growing health systems. With 15 hospitals, annual revenues of over $6 billion, and a service area that covers 75% of the state of Michigan, McLaren is committed to the highest levels of patient care.

McLaren Physician Partners is a joint venture partnership between the McLaren healthcare System and our Physician members. Our focus is to support physician offices in all aspects of care delivery and operations including clinical integration, contracting, quality, care coordination and care management, across all settings.

Position Summary:

Responsible for assisting the Leadership Team in all aspects of Third-Party Payor contracting activities within all market segments for McLaren Physician Partners (MPP), McLaren High Performance Network (MHPN), McLaren Health Care Corporation (MHCC), and its subsidiaries.Maintains an understanding of the impact negotiations have on population health and value-based contracting. Professionally and effectively communicates the advantages of contracting with McLaren, provides ongoing expertise throughout the contracting process and administration of payor agreements.Key team resource to the Leadership Team.

Essential Functions and Responsibilities:

• Acts as liaison between contracted Health Plans and MPP, MHPN, MHCC and subsidiaries.
• Maintains organizational documents for educating appropriate subsidiaries on managed care contracts, including but not limited to contract database and matrixes.
• Collaborates with the team on implementation of Corporate Initiatives, including but not limited to new or expanded services.
• Leads negotiations and coordinates contract workflow for assigned plans .
• Reviews contract language, redlining documents and evaluating areas of concern, as needed.
• Facilitates problem solving of escalated contractual, payor policy and operational issues through collaboration with managed care organizations and internal stakeholders.
• Facilitates Joint Operating Committee (JOC) meetings and related tasks with each payor or as required by contract.
• Conducts contract modeling and analysis for facility and physician contract rate proposals to support organization contracting strategies.
• Analyzes changes in payer policies, rules and regulations impacting both facility and physician payments. Communicates and educates those impacted, as necessary.
  
  

This position is fully remote.

Equal Opportunity Employer of Minorities/Females/Disabled/Veterans

QUALIFICATIONS:

Required:

• Bachelor’s degree in business, health care or related field; or an Associate degree and two (2) years’ experience in managed care; or a high school diploma or equivalent and four (4) years’ experience in managed care.
• An additional five (5) years’ experience in contracting or networking in a managed care organization, Health Plan, PHO, PO or similar organization.
  
  

Preferred:

• Master’s degree in health care management, finance or related field.
• Two (2) years’ experience with plan and provider contracting with both Facility and Professional.
  
  

Additional Information

• Schedule: Full-time
• Requisition ID: 24008138
• Daily Work Times: 8:30-5:00
• Hours Per Pay Period: 80
• On Call: No
• Weekends: No