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Coordinator Managed Care
4 months ago
We are looking for a Managed Care Coordinator 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 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.
This is a fully remote position.
Equal Opportunity Employer of Minorities/Females/Disabled/Veterans
#LI-AK1
QUALIFICATIONS:
Required:
- Bachelor's Degree in business, health care or related field.
- Two years' experience in a Managed Care organization, Health Plan, PHO, PO or similar organization.
- 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.
- Master's degree in health care management, Finance or related field.
- Five+ (5) years' experience in provider contracting and servicing.
- Established relationships with Health Plans, other Industry Professionals.
