About Us
McLaren Health Care is a fully integrated health network committed to quality, evidence-based patient care with locations in Michigan and Indiana. The McLaren system includes 13 hospitals in Michigan, ambulatory surgery centers, imaging centers, a primary and specialty care physician network, commercial and Medicaid HMOs, home health, infusion and hospice providers, pharmacy services, a clinical laboratory network and a wholly owned medical malpractice insurance company. McLaren operates Michigan’s largest network of cancer centers and providers, anchored by the Karmanos Cancer Institute, one of only 53 National Cancer Institute-designated comprehensive cancer centers in the U.S.
Business Analyst I, MI - Remote
We are looking for a Business Analyst I 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:
At the direction of the Business Information assigned leadership, coordinates, collects, and reports healthcare data by extracting, manipulating, converting and integrating data to and from various systems. Writes, modifies, and executes various production, management, regulatory, customer and ad hoc reports. Responsible for routine maintenance of the claims adjudication system provider data, benefits, and pricing configuration. Assists in maintaining a master library of benefits-related documents, including Certificates of Coverage, Benefit Summaries, Summary Plan Descriptions, regulatory filing documents and benefits/reimbursement policy. Maintains claim-related code tables, including procedure, diagnosis, place of service, revenue and DRG codes in the claims adjudication system.
This position is fully remote.
Equal Opportunity Employer of Minorities/Females/Disabled/Veterans
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Qualifications:
Required:
- Associate Degree in business, computer science, health care; or IT certification and two (2) years of current related experience.
- Two (2) years of current related experience.
Preferred:
- Two (2) years’ experience with report development and data mining software such as SSRS and Crystal Reports.
- Four (4) years’ experience in computer applications or database administration.
- Three (3) years’ experience and knowledge of HMO, PPO, TPA, PHO and Managed Care functions (e.g. accounting/finance, reinsurance, EDI, marketing, administration, medical delivery, regulatory compliance, claims processing, membership/eligibility, contracting and risk arrangements and actuarial precepts).
Equal Opportunity Employer
McLaren Health Care is an Equal Opportunity Employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, sexual orientation, gender identification, age, sex, marital status, national origin, disability, genetic information, height or weight, protected veteran or other classification protected by law.
