UCare

Provider Network Coordinator

7 days left

Employer
Location
Minneapolis, Minnesota
Posted
Aug 17, 2017
Closes
Oct 02, 2017
Employment Status
Full Time

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 225,000 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.

 

 

ABOUT UCARE

At UCare, we deliver high-quality health coverage and services to help members of all ages maintain and improve their health. It's a big job that takes innovative ideas, strategic partnerships, and a commitment to doing the right thing. Above all, it takes a compassionate team that is dedicated to making a real difference in the lives of our members and our communities.

 

WORKING AT UCARE

Working at UCare is more than just a career; it's a mission. A mission that defines us as professionals, unites us as an organization, and shapes how we interact with our members and each other. Our values of integrity, community, quality, flexibility, and respect permeate every aspect of our organization - from who we are and how we act, to what we do and how we do it. We owe our continued success to our employees who proudly embody our mission and values in everything they do.

 

PROVIDER NETWORK COORDINATOR

Position Description

The incumbent is expected to spend 75% of his/her time working with internal UCare Staff.  Serve as a liaison between PRC and other internal departments to ensure accurate translation and consistent communication between the teams that PRC interacts with.  Coordinate processes for clinic closings, NCQA, new products, network expansion, department metrics, department policies and procedures, for the department.  Specific duties and responsibilities include: 

Assist in the compliance, documentation, and enhancement of the provider contracting and reporting process in UCare's systems.

Support contract audits, compliance projects and routine reporting.

Accurately plan, train, audit and document PRC access to contract software. Train PRC staff on software capabilities and updates.

Participate in PEC/PRC/Credentialing meetings and serve as a liaison between the departments.  Ensure data is accurate, translated and consistently communicated between the departments.

Coordinate and manage the online provider change forms and assign work according to PRC assignments.

Assist in the coordination of the retro contract process

Generate reports as needed.

Coordinate termination process within PRC

Train, document and audit UCare staff access to contract software.  Routinely audit and maintain appropriate documentation as staff and staff responsibilities change so that contract access is job relevant

Work with team to ensure that contract management software usage is maximized and effectively monitored.

Support the provider directory and HSD table update processes, including   GeoAccess Mapping requests, and data validation.  Enhance skills as appropriate to best track, monitor, report and enhance UCare's provider network.

Act as a liaison within Provider Relations and work groups.  Work with the project team to develop, collect, analyze and prepare reports related to RFPs and network expansion.

Maintain strict member, administrative, and provider confidentiality.

Other projects and duties as assigned.

Education

Bachelor's degree or equivalent in health care management, or related field preferred; demonstrated work experience may be considered in lieu of degree.

 

Required Experience

Three years of experience in a health delivery setting, such as physician group practice, health insurance, HMO or community service agency, experience working cross departmentally, contract or database/document management, or project experience preferable. Previous experience a plus.

THE UCARE DIFFERENCE

UCare is proud to be a recognized Star Tribune Top Workplace for the 8th consecutive year. As a part of our collaborative team, you'll experience the rewards that come with helping others and seeing the positive results of your hard work. We value and respect each individual's ideas and contributions, and give you the freedom to grow both personally and professionally. We are centrally located, and offer onsite education, equipment and wellness resources, a myriad of volunteer activities, and a number of other rewards. If you're looking for a welcoming environment that celebrates what you have to offer, helps you build on your strengths, and gives you the opportunity to truly make a difference, we invite you to apply.

 

As an Equal Opportunity/Affirmative Action Employer, we welcome and employ a diverse employee group committed to meeting the needs of UCare, our members, and the communities we serve.

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. At UCare, we welcome and employ a diverse employee group committed to meeting the needs of UCare, our members, and the communities we serve.
www.ucare.org/careers/
EOE/AA

More jobs like this