Meridian Health Plan Benefit Configuration Analyst in Detroit, Michigan
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.
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
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.
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
Business LineCMC Corporate