Managed Care Operations Analyst

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 with U.S.-based teams to deliver strategic insights, operational excellence and specialized expertise that advance our Mission. Join a global team focused on meaningful healthcare impact.

Job summary

The Managed Care Operations Analyst supports managed care contract operations, compliance and reimbursement accuracy. This role ensures payer agreements are maintained, interpreted and analyzed correctly to protect revenue and support informed decision-making.

Operating within a Global Business Services environment, this role partners with U.S. stakeholders to drive operational excellence, contract visibility and service delivery outcomes in a healthcare setting.

What you’ll do

• Analyze managed care contracts to ensure alignment with organizational standards and regulatory requirements
• Maintain contract repository data, ensuring accurate records, timely updates and milestone tracking
• Coordinate system updates and support training for contracting tools and processes
• Research and document contract terms, fee schedules and payer policies
• Prepare analyses, summaries and reports to support managed care leadership decisions
• Maintain an inventory of payer contracts and participating payers for operational visibility
• Respond to internal inquiries by interpreting contract terms and providing clear guidance
• Monitor payer policy updates and communicate impacts to stakeholders
• Collaborate with revenue analytics teams to assess financial impact and validate fee schedules
• Investigate claims and reimbursement issues and support resolution efforts with payers
• Draft correspondence related to contract compliance, documentation requests and disputes
• Coordinate dispute resolution activities, including documentation tracking and follow-through
• Identify opportunities for process improvement to enhance accuracy, efficiency and standardization
• Collaborate with cross-functional teams to ensure consistent contract and payer policy execution

Requirements

• 1 year of experience in managed care, revenue cycle or payer operations within a healthcare or payer environment required
• Knowledge of managed care contracting, reimbursement methodologies and claims processing required
• Knowledge of data analysis, reporting tools or contract management systems preferred
• Knowledge of value-based payment models such as bundled payments or shared savings preferred

Education

• Bachelor’s degree in business administration, finance, accounting, information systems, mathematics, economics, statistics or related field required

Skills and abilities

• Strong understanding of managed care contract language and reimbursement structures including government and commercial payers
• Ability to review and interpret contract documents and summarize key changes and requirements
• Analytical skills to evaluate reimbursement issues and assess financial impact
• Proficiency in Microsoft Office applications including Excel, Word, PowerPoint and Outlook
• Experience working with healthcare systems, contract databases or reporting tools
• Strong organization skills with ability to manage multiple priorities in a fast-paced environment
• Effective written and verbal communication skills with ability to collaborate across teams
• High attention to detail and commitment to maintaining data accuracy and confidentiality

What we offer

• Comprehensive HMO medical coverage, retirement plan and group life and accident insurance
• One-time work from home allowance, connectivity allowance and wellness allowance
• Paid vacation and sick leave
• Government-mandated benefits: SSS, PhilHealth and Pag-IBIG contributions
• Flexible working model based on role and business need
• Mission-driven culture events, outreach and service opportunities
• Learning and development programs, mentorship and career growth pathways
• Collaborative office spaces and engagement activities

Benefits may vary based on employment terms and role.