Coordinator Managed Care

Coordinator Managed Care McLaren Health Care Corp - 3.2 Auburn Hills, MI Job Details Full-time 11 hours ago Qualifications Managed care organization experience Bachelor's degree in business Mid-level Contract management in healthcare High school diploma or GED Analysis skills Health insurance knowledge Organizational skills Contracts Contract management support tasks Healthcare reimbursement methods Business Associate's degree 2 years Full Job Description About Us McLaren Health Care, headquartered in Grand Blanc, Michigan, is a $7.3 billion, fully integrated health care delivery system committed to quality, evidence-based patient care and cost efficiency. The McLaren system includes 12 hospitals in Michigan, ambulatory surgery centers, imaging centers, a 640-member employed primary and specialty care physician network, commercial and Medicaid HMOs covering more than 732,838 lives in Michigan and Indiana, home health, infusion and hospice providers, pharmacy services, a clinical laboratory network and a wholly owned medical malpractice insurance company. McLaren operates Michigan's largest network of cancer centers and providers, anchored by the Karmanos Cancer Institute, a National Cancer Institute-designated comprehensive cancer centers. McLaren has 20,000 full-, part-time and contracted employees and more than 113,000 network providers throughout Michigan, Indiana and Ohio. Coordinator Managed Care Michigan, Auburn Hills NEW Non-Health Professional McLaren Health Care Corp 26002893

SUMMARY:

Responsible for implementing, operationalizing and administration of third-party payor/Managed Care agreements within all market segments for McLaren Physician Partners (MPP), McLaren Health Care Corporation (MHCC), McLaren High Performance Network (MHPN) and its subsidiaries. Assist and support of the relationships with Health Plans and third-party payors. Coordinate and facilitate education of hospitals, physicians, and staff relative to the operational, payment, quality programs and initiatives specific to each third-party payor, leads JOCs and resolution of issues as they may develop. Conducts contract modeling and analysis with an understanding of population health and value-based contracting. Professionally and effectively communicates the advantages of contracting with McLaren, provides ongoing support to the contract management team.

Required:

Associate degree in business, health care or related field; or a high school diploma or equivalent and two (2) years' experience in a Managed Care organization, Health Plan, PHO, PO, or similar organization An additional two (2) years' experience in a Managed Care organization, Health Plan, PHO, PO, or similar organization.

Preferred:

1. Bachelor's degree in business, health care or related field. 2. Experience with standard and innovative contract and reimbursement methodologies, including but not limited to fee for service, value-based payments, risk contracting, capitation and bundled payments. 3. Five+ (5) years' experience in provider contracting and servicing. 4. Established relationships with Health Plans, other Industry Professionals.

Additional Information Schedule:

Full-time Requisition ID:

26002893

Daily Work Times:

Standard Business Hours Hours Per Pay Period:

80

On Call:

No Weekends:

No McLaren Health Care is an Equal Opportunity Employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, sexual orientation, gender identification, age, sex, marital status, national origin, disability, genetic information, height or weight, protected veteran or other classification protected by law.