What are the responsibilities and job description for the Managed Care Contract Administrator, MPP - Remote position at McLaren Health Care Corp?
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
LI-AK1
QUALIFICATIONS : Required :
Preferred :
