Meridian Health Plan Benefit Configuration Analyst in Detroit, Michigan

Overview

Current Selection

Who we are:

Meridian is a family-owned, family-operated company of passionate leaders, achievers, and innovators dedicated to making a difference in the lives of our members, our providers and in the healthcare industry.

We provide government-based health plans (Medicare, Medicaid, and the Health Insurance Marketplace) in three different states (Michigan, Illinois, and Ohio).

Our employees work hard, play hard, and give back. Meridian employees enjoy: Happy hours, special events, company sports teams, potlucks, Bagel Fridays, weekly Executive Lunches, and volunteer opportunities.

A Day in the Life of a Benefit Configuration Analyst:

The Benefit Configuration Analyst provides both operational support to, and analysis of, all Benefit Configuration-related activities. The Benefit Configuration Analyst creates, updates, tests and maintains system configuration to support all benefit designs and ensure successful configuration and integration.

Responsibilities

  • Assist in translating benefits and details into system configuration parameters

  • Ensure compliance with the health plan policies for complete, accurate and consistent benefit plan design, resulting in appropriate benefit administration and data integrity

  • Review and revise business and plan design requirements for system set-ups and configurations

  • Assist in communicating issues and opportunities for improvement regarding the system enhancementsmedicaremed

  • Lead business requirements development and solution design process upon implementation of new clients and/or products

  • Develop new (and review/update existing) Policies & Procedures (P&P’s) in support of standardized and accurate benefit configuration

  • Maintain up-to-date knowledge of regulatory changes impacting benefit administration (e.g. ICD-10, ASC, DRG, CPT, HCPCS etc.)

  • Assist in creating and maintaining provider, member and staff materials that reflect appropriate benefits for all programs

  • Educate CMC employees on company policies and procedures regarding benefit plan designs

  • Remain updated on all member and provider policy changes made by the health plan, CMS and/or the State

  • Compile information and prepare reports and analyses of results of benefit configuration findings including appropriate recommendations

  • Assist all internal and external stakeholders with reports as requested

Qualifications

Current Selection

What you can bring to Meridian:

  • Bachelor’s degree or Fellow Designation from the Academy of Healthcare Management (AHM) is required

  • Demonstrated adaptability and flexibility to changes and response to new ideas and approaches is required

  • Knowledge of managed care and the Medicaid program is required

  • Knowledge of the health plan programs, benefits, and services for all lines of business is preferred

  • Knowledge of National Committee for Quality Assurance (NCQA), URAC or general accreditation standards is preferred

  • Knowledge of appeal and grievance guidelines is preferred

  • Superior analytical and problem solving skills and excellent computer skills are required.

Current Selection

What Meridian can offer you:

  • Our healthcare benefits include a variety of PPO plans that are effective on the first day of employment for our new full-time team members.

  • Opportunity to work with the industry’s leading technologies and participate in unique projects, demonstrations, conferences, and exclusive learning opportunities.

  • Meridian offers 401k matching that is above the national average.

  • Full-time Meridian employees are eligible for tuition reimbursement towards Bachelor’s or Master’s degrees.

  • Meridian was named Detroit's #1 Fastest Growing Company by Crain's Magazine, so it is a great time to get involved with Meridian.

Equal Opportunity Employer

#MSTR

Job ID2018-5453

CategoryOperations

Business LineCMC Corporate