Manager, Care Management Department

Health Care that Starts with You!

Join a truly mission driven organization! Independent, nonprofit UCare is recognized as one of the Minnesota’s leading health plans. We provide more than 175,000 members across Minnesota and western Wisconsin with the health coverage plans and services they need to maintain and improve their health. The innovative coverage we create makes a difference for Medicare-eligible individuals, individuals and families enrolled in Minnesota Health Care Programs, such as MinnesotaCare and Medical Assistance, and disabled adults with special health care needs.

UCare is growing in size, membership, products, geographic coverage, and employees. We’re an organization that’s going places. Be part of a team that cares about you, be part of UCare.

Manager, Care Management Department

Working with the Director of Care Management, this is an excellent opportunity for an experienced manager with a case management background to take on a key role within a growing, vibrant, nationally recognized organization. We’ll count on you to use your experience to help develop and implement UCare's overall medical management strategy and case management functions. Other duties include helping to ensure compliance with Medicaid, Medicare, Minnesota statute and contractual obligations, and more.

Responsibilities:
• Oversees the case management team in the performance of case management assessments, development and implementation of care plans and the evaluation of care outcomes.
• Represents UCare at external meetings and with regulators on UCare case management policies and procedures. Works collaboratively with other health plans and DHS on those matters that can be coordinated without risk to market positioning.
• Identifies and makes recommendations to Medical Leadership on screening criteria for case management and evaluates the efficacy of the screening criteria. Assigns and allocates workload to case managers.
• Works closely with the Clinical Intake and Operations Manager in interpreting, and consistently applying utilization review and benefit criteria.
• Works closely with the Disease Management Manager and Quality Management staff in integrating case management into disease management and quality improvement projects.
• Trains case managers on MSHO, Medicare Advantage and PMAP requirements and processes for case management. Develops tools and resources to assist the case managers in performing their duties, including assessment, care plans, and nursing algorithms for commonly occurring clinical and psycho-social issues.

Qualifications:
• Bachelor's degree in Nursing
• MN RN licensure
• 5+ years in case management
• 3+ years in a supervisory role
• Knowledge of working Medicare/Medicaid compliance
• Case management certification and experience with Minnesota Senior Health Options (MSHO) desirable
• Master's degree preferred

Rewards:
Enter a highly collaborative environment where people are truly engaged, and feedback is valued. You’ll enjoy a competitive salary and benefits, as well as a host of other perks, including a nationally recognized wellness program, and a bright, open, award-winning office space in Northeast Minneapolis—just minutes from major freeways and retail centers.

Learn more and apply
Visit us at http://www.ucare.org/careers/Pages/CareManagementManager1240.aspx

EOE/AA

UCare provides more than 160,000 health plan members with the health coverage plans and services they need to maintain and improve their health.