Job Location: Flint, MI
Job Detail:
We are looking for a Data Analyst Administrator Michigan to join us in leading our organization forward.
McLaren Integrated HMO Group (MIG), a division of McLaren Health Care Corporation, is an organization with a culture of high performance and a mission to help people live healthier and more satisfying lives.
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 is our Michigan-based health plan dedicated to meeting the health care needs of each of our Michigan members. Learn more about McLaren Health Plan at https://www.mclarenhealthplan.org
MDwise is our Indiana-based health plan, working with the State of Indiana and Centers for Medicare and Medicaid Services to bring you 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 unites. 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 will be a 100% remote opportunity.
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.
- 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).
- Professional Certification in applicable programs (i.e. Healthcare Quality (CPHQ); Analytics Professional (CAP))
- Proficiency with PowerBI
Equal Opportunity Employer of Minorities/Females/Disabled/Veterans
Additional Information
- Schedule: Full-time
- Requisition ID: 23000452
- Daily Work Times: 8:30am-5:00pm
- Hours Per Pay Period: 80
- On Call: No
- Weekends: No
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