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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 theoperational, 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:
- Bachelor’s degree in business, health care or related field.
- 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.
- Five+ (5) years’ experience in provider contracting and servicing.
- 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
