The Managed Care Contracting Analyst is responsible for financial modeling and economic analysis to support fee-for-service and risk-based contracting strategy, evaluating contract performance, forecasting value-based reimbursement impacts, and identifying optimization opportunities for MyMichigan Collaborative Care Organization (MCCO) and MyMichigan Health. The role collaborates closely with the Managed Care Contracting and Finance teams to inform negotiations and strategic decisions through data-driven insights This role uses tools to generate reports, dashboards and analytical solutions according to business rules and specifications and is responsible for supporting the Managed Care Contracting department through the analysis and review of financial performance of managed care contracts.
Responsibilities
(50%)* Performs contract analysis and evaluation to assess performance and identify opportunities for MCCO and MyMichigan Health improvement, cost savings, and revenue enhancement. Analyzes and monitors payor trends, managed care contract compliance, contract and payor yield, and indicators that reflect new opportunities for revenue or charge capture that align with MCCO and health system organizational goals. Conduct contract modeling and scenario analysis to assess the impact of proposed contract changes.
(40%)* Responsible for data management and reporting including the collection, validation, and management of data related to managed care contracts. Develops and maintains robust reporting mechanisms to monitor key performance indicators, financial metrics, and contract performance and provides regular reports to MCCO leadership, MyMichigan Health executive leadership, and relevant stakeholders.
(10%)* Support charge master benchmarking and revenue analytics by providing data needed for Finance leaders to make recommendations on MyMichigan Healths strategic pricing.
Other Duties And Responsibilities
Collaborate with the contract negotiation team to provide data-driven insights and recommendations during contract negotiations with payers.
Assist in developing negotiation strategies to optimize reimbursement rates and contractual terms.
Work closely with cross-functional teams, including finance, legal, and operational departments, to ensure alignment in contract management strategies.
Collaborate with external stakeholders, such as payers and regulatory bodies, to stay informed about industry trends and changes.
Implement systems for monitoring and tracking key performance indicators related to managed care contracts. Inform MCCO leaders and teams on payor performance relative to JOC content.
Act as the liaison between Managed Care Contracting, Finance, and IT du