Managed Care Operations Analyst

Thank you for considering a career at Bon Secours Mercy Health! Scheduled Weekly Hours: 40 Work Shift: 8pm to 5am (Philippines) Bon Secours Mercy Health Global Business Services – Manila Who we are At Bon Secours Mercy Health Global Business Services – Manila, we believe your best is yet to come. Based in the Philippines, we partner closely with U.S.-based teams and leaders to deliver strategic insights, operational excellence and specialized expertise that advance our Mission. Join us in celebrating the human side of healthcare and be part of a global team dedicated to delivering meaningful impact. Job summary The Managed Care Operations Analyst supports managed care contract operations and compliance activities to ensure accurate reimbursement and adherence to pay o r agreements. This role is responsible for operational contract administration , fee schedule maintenance, policy documentation, and analytic s upport, providing insight and escalation support to managed care leadership. Essential functions Review managed care contracts to ensure alignment with organizational standards, regulatory requirements, and approved contract language frameworks. Maintain the contract repository database, ensuring accuracy, timely updates, milestone tracking, and serving as liaison for system updates and contracting staff training. Research, track, and document contract terms, fee schedules, and payer policies; prepare summary analyses and reports for managed care leadership. Maintain a comprehensive inventory of payer contracts and participating payers to support operational consistency and organizational visibility. Respond to internal inquiries regarding contract terms and conditions by conducting research and providing clear guidance and analysis. Monitor and communicate payer policy changes; support financial impact assessments in collaboration with Revenue Analytics, including fee schedule analysis. Investigate, document, and assist with claims and reimbursement issue resolution; serve as liaison with payers and support internal education on payer requirements. Draft routine correspondence to payers regarding contract compliance, documentation requests, and dispute initiation under leadership direction. Coordinate with managed care leadership and cross-functional stakeholders to support dispute resolution workflows, including documentation and issue tracking. Identify and implement process improvements to enhance efficiency, accuracy, and standardization in contract maintenance, payer policy review, and related workflows. This document is not an exhaustive list of all responsibilities, skills, duties, requirements, or working conditions associated with the job. Employees may be required to perform other job-related duties as required by their supervisor, subject to reasonable accommodation. Education Bachelor’s degree in information systems, business administration, finance, accounting, Mathematics, economics, statistics, or a related discipline. (required) Required licensing and certifications Experience 1 years of experience working in an acute care facility’s managed care department or for a payor, or a combination of related consulting experience (required) Experience supporting analytics, reporting, contracting, claims resolution and/ or payer relations ( preferred ) Experience with SQL , Crystal Reports, or similar reporting tools (preferred) Experience with contract management systems (e.g., MediTract , nThrive , or Symplr ) , epic, and accessing third party portal s (preferred) Proven experience in project management, preferably within a health system (preferred) Skills and abilities Strong knowledge of managed care contract language, reimbursement methodologies (CMS, Medicaid, and commercial), claims processing, and related regulatory requirements. Ability to review and redline contract documents, summarize proposed changes, and prepare clear supporting documentation and correspondence for leadership review. Analytical and problem-solving skills to research reimbursement issues, validate fee schedules and payment logic (e.g., within Epic or similar systems), assess financial impact , and escalate risks as appropriate . Experience supporting value-based payment arrangements (e.g., shared savings, bundled payments) through data analysis, reporting, or operational monitoring. Proficiency in Microsoft Office Suite (Word, Excel, PowerPoint, Outlook) and experience working with database-driven or project management systems. Strong organizational skills with the ability to manage multiple projects, prioritize competing deadlines, and adapt in a fast-paced environment. Effective written and verbal communication skills, with the ability to build collaborative relationships with internal stakeholders and external payer representatives. High level of professionalism, discretion, and ability to maintain confidentiality of sensitive patient , contract , and organizational information. As a Bon Secours Mercy Health associate, you’re part of a Mission that matters. We support your well-being – personally and professionally. Our benefits are built to grow with you and meet your unique needs, every step of the way. What we offer Comprehensive HMO medical coverage, retirement plan and group life and accident insurance One-time Work From Home allowance, connectivity allowance, wellness allowance and role-specific allowances Paid vacation and sick leave Government-mandated benefits: SSS, PhilHealth and Pag-IBIG contributions Flexible working model with hybrid, onsite or virtual arrangements (based on role and business need) Mission-driven culture events, community outreach and service opportunities Learning and development programs, mentorship and clear career growth pathways Modern, collaborative office spaces and regular engagement and culture-building activities Benefits may vary based on employment terms and role. Department: Finance Operations - Core - BSMH Global Business Systems It is our policy to comply with all applicable Philippine labor laws and regulations and to uphold equal employment opportunity in all aspects of recruitment and employment. All applicants will be considered for employment based on merit, qualifications, and business requirements, without regard to race, color, ethnicity, religion, sex, sexual orientation, gender identity or expression, civil status, age, disability, genetic information, nationality, or any other status protected under Philippine law. We are committed to providing an inclusive workplace free from unlawful discrimination and harassment. If you are a person with a disability and require reasonable accommodation as part of the application or selection process, please contact the Talent Acquisition Team at [email protected] . We will work with you to provide appropriate assistance in accordance with applicable laws and company policy.