A cover letter is required for consideration for this position and should be attached as the first page of your resume. The cover letter should address your specific interest in the position and outline skills and experience that directly relate to this position.
The Contracting Office is responsible for the administration of managed care contract agreements between Michigan Medicine and a wide range of healthcare delivery options. The Business Analyst Senior position will provide assistance to the Contracting Office’s efforts related to negotiations, payer relations, operations, education, and report analysis of our contractual agreements, including monitoring healthcare payer contracts. In addition, the candidate will help address and resolve payer contractual and operational issues. Assignments are complex in nature, requiring very detailed, timely work and thorough investigation. This position meets regularly with our contracted payers to address contractual, operational, and reimbursement issues, and also interfaces with a wide range of areas within Michigan Medicine. Responsibilities also include developing and maintaining a wide variety of tools and resources designed to assist staff with contractual and operational issues as well as help communicate and educate staff on payer updates and changes.
Primary responsibilities are dedicated to providing oversight of managed care payer agreements, negotiating single case agreements related to new technology, congenital heart, solid organ and BMT, Kidney-Paired Donor Agreements, behavioral health, and a variety of regional and national referrals to Michigan Medicine.
Review new contracts and vet operational requirements with applicable clinical areas and Revenue Cycle to ensure compliance, as well as help develop master process flows, build tools to aid clinical areas, and ensure proper process of notification is in place.
Analyze, compare, and evaluate various financial terms, with the authority to make independent decisions on significant financial matters which impact Michigan Medicine revenue.
Review and make recommendations on payer/plan codes for MiChart.
Analyze and interpret statistical data, including medical and financial information to assist with cellular and genetic therapy referrals/cases as well as those on behalf of our existing contracts.
Assist departments in facilitating the network requirements to be enrolled in and maintain our Center of Excellence (COE) status.
Utilize specific software in the creation, display, and reproduction of charts, graphs, and economic models relative to the financial/operations of the organization.
Seek out health plan statistics from various sources to create reports used to guide contracting decisions.
Provides support on behalf of all our payer contracts and help to resolve operational and/or systemic issues related to payer requirements.
Provides assistance to multiple areas within Michigan Medicine on payer related issues.
Work closely with clinical areas and revenue cycle staff to communicate financial terms of contract agreements to ensure accuracy and compliance of payer contracts, including single case agreements and/or Transplant arrangements.
Work closely with assigned payer representatives on a wide array of financial and operational issues which at time can be complex in nature, requiring very detailed work.
Work closely with front and back end staff to help educate and communicate payer updates and changes.
Prepare contract updates and communicate information in various forums/presentations.
Create individual department tools and maintain web-based resources for internal department website to assist clinic and revenue cycle staff, and contribute articles to the Newsflash newsletter. Also manage insurance list for external website @ uofmhealth.org .
Monitor and respond in a timely fashion to Contracting inquiries submitted to the Contracting Office’s department email inbox.
Develop and leverage connections with health plans for the purposes of supporting Michigan Medicine’s contracts and strategic goals.
Minimum 5 years experience working with Managed Care health plans
Comprehensive understanding of healthcare regulatory CMS requirements, healthcare reform and reimbursement strategies.
Strong analytical, organizational, and decision-making skills.
Comprehensive understanding of Michigan Medicine infrastructure and business processes.
Excellent oral and written communication skills and the ability to work effectively across Michigan Medicine.
Excellent understanding of Managed Care plans, health insurance concepts, and insurance related functions, processes, and requirements.
Ability to work both independently and as part of a team environment.
Ability to handle multi-faceted tasks in a fast- paced work environment while maintaining the level of detail critical to contracts/operations.
Competent utilizing a wide variety of Microsoft Office programs, including but not limited to Microsoft word, powerpoint, and excel, as well as experience with Adobe Dreamweaver.
Solid understanding and experience with MiChart functionality.
Michigan Medicine conducts background screening and pre-employment drug testing on job candidates upon acceptance of a contingent job offer and may use a third party administrator to conduct background screenings. Background screenings are performed in compliance with the Fair Credit Report Act. Pre-employment drug testing applies to all selected candidates, including new or additional faculty and staff appointments, as well as transfers from other U-M campuses.
Michigan Medicine improves the health of patients, populations and communities through excellence in education, patient care, community service, research and technology development, and through leadership activities in Michigan, nationally and internationally. Our mission is guided by our Strategic Principles and has three critical components; patient care, education and research that together enhance our contribution to society.
Job openings are posted for a minimum of seven calendar days. This job may be removed from posting boards and filled anytime after the minimum posting period has ended.
The University of Michigan is an equal opportunity/affirmative action employer.
Internal Number: 199283
About University of Michigan - Ann Arbor
A great university is made so by its faculty and staff, and Michigan is recognized as one of the best universities to work for in the country. The Michigan culture is known for engaging faculty and staff in all facets of the university to create a workplace that is vibrant and stimulating.For two consecutive years, the Chronicle of Higher Education has placed U-M in its "Great Colleges to Work For" survey. In particular, the university earns high marks for strong relations between faculty and administrators, a collaborative system of governance, strong pay and benefits, and a healthy work/life balance.