Data Analytics Administrator, MI - Remote

We are looking for a Health Plan Data Analytics Administrator, to join us in leading our organization forward.

McLaren Integrated HMO Group (MIG) is a fully owned subsidiary of McLaren Health Care Corporation and is the parent company of McLaren Health Plan in Michigan and MDwise, Inc. in Indiana. MIG was founded in 2018 when MDwise, Inc. joined the McLaren family. MIG provides leadership, integration opportunities, oversight, direction and support to the McLaren health plans.

McLaren Health Plan and MDwise, Inc., subsidiaries of MIG, value the talents and abilities of all our employees and seeks to foster an open, cooperative and dynamic environment in which employees and the health plans can thrive. As an employee MIG, you will be a part of a dynamic organization that considers all our employees as leaders in driving the organization forward and delivering quality service to all our members.

McLaren Health Plan (MHP) a subsidiary of McLaren Integrated HMO Group, is a Health Maintenance Organization (HMO), dedicated to meeting the health care needs of each member. The HMO was started to serve Michigan's Medicaid population and has added individual and Medicare products along with a Third-Party Administrator called Health Advantage, Inc., the McLaren Employee Plan. Learn more about McLaren Health Plan at https://www.mclarenhealthplan.org

MDwise, a subsidiary of McLaren Integrated HMO Group, is an Indiana-based nonprofit health care company. MDwise was founded in 1994 to help vulnerable populations needing health coverage in Indiana. The mission is to provide high quality health care. MDwise only takes care of families in Indiana. MDwise works with the State of Indiana and Centers for Medicare and Medicaid Services to bring the residents of Indiana the Hoosier Healthwise and Healthy Indiana Plan health insurance programs. Learn more about MDwise, Inc. at https://www.mdwise.org/

Position Summary:

Responsible for managing and providing complex economic analytical support for financial reporting, contract modeling, MLR Initiatives, Quality Programs, HEDIS, NCQA, rate filings and strategic initiatives. Manages the support and ongoing analysis of the managed care relationship with providers, regulatory agencies, and internal business units. Role interacts with and supports internal and external stakeholders at all levels of the organization, up to and including executive teams. Assists and/or leads assigned teams in developing and providing complex economic analytics for business decision support. Assists where necessary or through project management those business ventures undertaken by the Company to ensure its profitable future.

This position is fully remote.

Equal Opportunity Employer of Minorities/Females/Disabled/Veterans

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Qualifications:

Required:

• Associate degree in health administration, health policy, finance or a related field;

• Five (5) years' experience in the areas of managed care analytics and risk management, Medicare Advantage programs, Medicaid/Medicare payment practices and policies, finance, network contracting, and/or clinical program cost-effectiveness analytics, including at least two (2) years' experience working in complex SQL, Databases and Microsoft office related tools.

OR

• Eight (8) years' experience in the areas of managed care analytics and risk management, Medicare Advantage programs, Medicaid/Medicare payment practices and policies, finance, network contracting, and/or clinical program cost-effectiveness analytics, including at least two (2) years' experience working in complex SQL, Databases and Microsoft office related tools.

Preferred:

• Bachelor's degree in business, health administration, health policy, finance or a related field.

• Professional Certification in applicable programs (i.e. Healthcare Quality (CPHQ); Analytics Professional (CAP)).

• Five (5) years' experience and knowledge of HMO, PPO, TPA, PHO and Managed Care functions (e.g. finance, medical delivery, regulatory compliance, claims processing, membership/eligibility, contracting and risk arrangements and actuarial precepts).

• Schedule: Full-time
• Requisition ID: 25001296
• Daily Work Times: 8:00 am - 5:00 pm
• Hours Per Pay Period: 80
• On Call: No
• Weekends: No