Managed Care Operations Analyst

Proselect Management Inc; Taguig; On-site; PHP 500,000 - 700,000; Full time

Job summary

A healthcare management firm is seeking a Managed Care Analyst to support the managed care department. The role involves providing analytical, reporting, and project support related to payer contracts and claims resolution. Candidates should have at least 1 year of experience in managed care or healthcare consulting, with strong skills in analytics and project management. Proficiency in SQL and Microsoft Office is required, and candidates should be adept at managing multiple priorities in a fast-paced environment.

Qualifications

• 1+ year of experience in managed care or related healthcare consulting.
• Experience in analytics, reporting, contracting, or claims resolution is preferred.
• Strong understanding of managed care contract language and regulatory requirements.

Responsibilities

• Provide analytical support related to payer contracts and claims resolution.
• Maintain reports and assist in contract management.
• Contribute to projects that improve managed care operations.

Skills

Analytical skills

Attention to detail

Project management

Relationship building

Problem-solving

Tools

SQL

Crystal Reports

Microsoft Office Suite

Contract management systems

Epic

Job description

The Managed Care Analyst supports the managed care department by providing analytical, reporting, and project support related to payer contracts, claims resolution, and payer relations. This role works closely with internal teams and external payors to ensure contract compliance, accurate reimbursement, and timely resolution of issues impacting revenue.

The analyst is responsible for maintaining reports, assisting in contract management, supporting payer communications, and contributing to projects that improve managed care operations and financial performance. This position requires strong analytical skills, attention to detail, and the ability to manage multiple priorities in a fast-paced healthcare environment.

Qualifications

• 1+ year of experience working in an acute care facility’s managed care department, for a payor, or a combination of related healthcare consulting experience (required)
• Experience supporting analytics, reporting, contracting, claims resolution, and/or payer relations (preferred)
• Experience using SQL, Crystal Reports, or similar reporting tools (preferred)
• Familiarity with contract management systems (e.g., MediTract, nThrive, Symplr), Epic, and third-party payer portals (preferred)
• Proven experience in project management, preferably within a health system
• Strong understanding of managed care contract language, claims processing, payer policies, and regulatory requirements
• Excellent organizational and planning skills with the ability to manage multiple projects and timelines
• Advanced proficiency in Microsoft Office Suite (Word, Excel, PowerPoint, Outlook, Visio)
• Ability to build effective relationships with diverse internal and external stakeholders
• Strong analytical, problem-solving, and attention-to-detail skills