Managed Care Operations Analyst

Bon Secours; Philippines; Hybrid; PHP 600,000 - 900,000; Full time

Benefits offered by this job

Hybrid work arrangements

Work-life balance programs

HMO medical coverage

Retirement plan benefits

Paid vacation and sick leave

Job summary

Bon Secours Mercy Health Global Business Services – Manila is seeking a Managed Care Operations Analyst to support contract operations and compliance, ensuring accurate reimbursement and adherence to payor agreements. The role covers contract administration, fee schedule maintenance, policy documentation, and analytics support for leadership.

The position requires a Bachelor’s degree in a related field and experience with contract management systems, SQL, and reporting tools.

Qualifications

• Bachelor’s degree in information systems, business administration, finance, accounting, Mathematics, economics, statistics, or a related discipline.
• 1 year of experience in a managed care setting or payer environment.
• Experience with SQL, Crystal Reports, or similar reporting tools.
• Experience with contract management systems and access portals.

Responsibilities

• Review managed care contracts for alignment with standards, regulatory requirements, and approved language frameworks.
• Maintain contract repository with timely updates and staff training liaison.
• Research and document contract terms, fee schedules, and payer policies; prepare analyses for leadership.
• Monitor payer policy changes and support financial impact assessments with Revenue Analytics.
• Assist with claims and reimbursement issue resolution and liaise with payers.

Skills

Managed care knowledge

Contract analysis

Analytical skills

Communication skills

Project management

Education

Bachelor’s degree in information systems / business administration / finance

Tools

SQL

Crystal Reports

MediTract

nThrive

Symplr

Epic

Job description

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

TheManaged Care OperationsAnalyst supportsmanaged carecontractoperations andcompliance activities to ensureaccuratereimbursement and adherence to payor agreements. This roleis responsible foroperationalcontractadministration, fee schedule maintenance, policy documentation, and analyticsupport, 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,timelyupdates, milestone tracking, and serving asliaisonfor 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 inquiriesregardingcontract terms and conditions by conducting research and providing clear guidance and analysis.


• Monitor and communicate payer policy changes; supportfinancial impactassessments in collaboration with Revenue Analytics, including fee schedule analysis.


• Investigate, document, andassistwith claims and reimbursement issue resolution; serve as liaison with payers and support internal education on payer requirements.


• Draft routine correspondence to payersregardingcontract 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.


• Identifyand implement process improvements to enhance efficiency, accuracy, and standardization in contract maintenance,payerpolicy 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 maybe requiredto perform otherjob-relatedduties 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)

Experience

• 1years 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/orpayer relations(preferred)


• Experience with SQL, Crystal Reports, or similar reporting tools(preferred)


• Experience withcontractmanagement systems(e.g.,MediTract,nThrive, orSymplr), epic, and accessing third party portals(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,validatefee schedules and payment logic (e.g., within Epic or similar systems), assessfinancial impact, and elevate risks asappropriate.


• Experience supporting value-based payment arrangements (e.g., shared savings, bundled payments) through data analysis, reporting, or operational monitoring.


• Proficiencyin 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 levelof professionalism, discretion, and ability tomaintainconfidentiality of sensitivepatient,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 @bsmhealth.org. We will work with you to provide appropriate assistance in accordance with applicable laws and company policy.