The Managed Care Contracting and Operations Office is responsible for the negotiation, implementation, administration, and operations of managed care agreements on behalf of Michigan Medicine, Sparrow Health System, and UMHWest with all payers. The Managed Care Payer Specialist will report to the Manager, Managed Care Operations and will assist in supporting the department with the day-to-day operations of all payer contracts for all three health systems. The Managed Care Payer Specialist plays a vital role in ensuring transparent and effective communication between the managed care organization and its payers, contributing to positive relationships, and the overall success of the organization's managed care programs.

• Collect and coordinate communications based on information received from external payers.
• Monitor, review for appropriateness, and respond to payer updates communicated to the department email inbox in a timely manner.
• Review updates against contractual appropriateness, organize and disseminate information by functional/operational areas for all three health sites.
• Collaborate with the Manager, Managed Care Operations to create and distribute periodic update reports for all functional/operational areas.
• Create succinct and informative content, such as newsletters, FAQs, and presentations tailored to all applicable functional/operational areas.
• Communicate changes in payer policies, regulations, and compliance requirements to impacted departments, ensuring they are informed of appropriate updates.
•  Assist Manager, Managed Care Operations with developing a comprehensive and efficient communication strategy for payer update(s) distribution.
• Collaborate with the Manager, Managed Care Operations to ensure accurate and timely dissemination of payer-related information.
• Analyze communication strategy effectiveness, gathering feedback to measure engagement and satisfaction levels.
• Assist multiple areas within Michigan Medicine, Sparrow Health System, and UMHWest on payer related issues.
• Participate in payer Joint Operating Committee Meetings (JOC) to ensure creation/dissemination of pertinent information is achieved.
• Assist in the oversight of the departments email box by reviewing, investigating, and responding to various inquiries. 
• Other duties as needed and/or assigned
   

• Associate's degree in healthcare administration, business, or related field.  
• Minimum of three (3) years of experience working in the healthcare industry or managed care organizations. 
• Excellent written and verbal communication skills, with the ability to convey complex information clearly and effectively.
• Strong interpersonal skills and ability to build and maintain relationships with diverse stakeholders both internal and external.
• Proven experience in payer communications within the healthcare or managed care industry.
• Proficiency in Microsoft Office Suite, including but not limited to Microsoft Excel, PowerPoint, and Word.
•  Detail-oriented with strong organizational, time management, and decision-making skills.
• Ability to work both independently and as part of a team environment in a hybrid environment.
•  Ability to manage multi-faceted tasks in a fast- paced work environment while maintaining the level of detail critical to managed care operations.
   

• Bachelor's degree in healthcare administration, business, or related field is preferred. Equivalent work experience is acceptable.

Positions that are eligible for hybrid or mobile/remote work mode are at the discretion of the hiring department. Work agreements are reviewed annually at a minimum and are subject to change at any time, and for any reason, throughout the course of employment. Learn more about the work modes.

The University of Michigan is an equal employment opportunity employer.