Operations Analyst

McLaren Health Plan (MHP) is a company with a culture of high performance and a mission to help people live healthier and more satisfying lives.  We are looking for an Operations Analyst, to join in leading the organization forward.

MHP is a Managed Care Organization dedicated to meeting the health care needs of each member. MHP offers multiple product lines, including individual and family plans, and Medicaid and Medicare plans to Michigan residents for every stage of life. McLaren Health Plan is accredited by the National Committee for Quality Assurance (NCQA).

MHP values the talents and abilities of all our employees and seeks to foster an open, cooperative and dynamic environment in which employees and the health plan can thrive. As an employee of MHP, 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.

Learn more about McLaren Health Plan at https://www.mclarenhealthplan.org

Position Summary:

The Operations Analyst combines executive-level support with hands-on operational execution to advance the strategic and day-to-day priorities of the health plan. This role provides end-to-end support for organizational initiatives and process improvements across all functions of the health plan. This individual will work with leaders across all departments to ensure operational compliance, alignment on goals, and timely execution of priority initiatives. The role manages executive-level communications, prepares leadership materials, completes special assignments, and supports high-visibility projects that require discretion, accuracy, and professionalism. Responds to inquiries, provides information, and independently resolves basic problems. Responsible for assisting in development of operating policies and procedures, taking and maintaining minutes of various committees, posting of announcements, and compiling and maintaining recurring and miscellaneous reports. Acts as a liaison with internal and external departments.

Position Specific Expectations:

Operations

1. Maintains, reviews, and managers MHP's system logs and follows up with users on open issues as required.

2. Serves in an advisory role to department reporting and special projects as assigned.

3. Utilizes analytics and reporting tools to monitor claims payment performance, identify emerging trends, and support data-driven decisions making.

4. Maintain payment analytics dashboards, KPIs, and metrics to measure financial performance, operational effectiveness, and payment accuracy. 

5. Analyze claims datasets to uncover root causes of overpayments, underpayments, and process inefficiencies, driving change.

6. Assist with workflows, identifying and resolving process discrepancies and operational bottlenecks to improve accuracy and turnaround times.

7. Partner with cross-functional teams to enhance controls, reduce rework, and optimize operational efficiency across operation system environments.

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Required:

• Associate degree in business administration, healthcare administration, or other administrative support area; or High School diploma or equivalent (GED) and two (2) years’ experience in a related field.

• Two years’ experience in an office environment related to customer service.

• Proficiency with computer applications, MS-Office, automation tools, and other software applications associated with Operations department functions.

Preferred:

• Bachelor’s degree in business administration, healthcare administration, or related field.

• Experience and knowledge of HMO, PPO, TPA, and Managed Care functions (e.g. quality improvement, regulatory compliance, utilization management, care management, claims processing, payment integrity, enrollment/eligibility, EDI, provider contracting, and risk arrangements).