Customer Service Compliance Coordinator
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 UCAREAt 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 UCAREWorking 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. CUSTOMER SERVICE COMPLIANCE COORDINATORPosition DescriptionThis position is responsible to collaborate with business partners and key stakeholders to identify, assess and respond to regulatory requirements and investigative inquiries. Design policies and procedures focused on mitigating risk and improving operational controls while maintaining a positive customer experience. Represent Customer Service when working across the organization to assess compliance needs and implementation risks in major initiatives. Apply knowledge of state and federal guidelines to the analysis of Customer Service functions. Prepare reports and provide analysis in an accurate, comprehensive and timely manner.·Provide support or project management for audit and compliance initiatives and assist in carrying out other related responsibilities as required by CS Manager.·Identify where compliance risks may exist, recognize areas for improving controls, and assess potential impacts to the business and our customers.·Ensure knowledge management tool is in compliance with UCare's governance policies.·Collaborate with the Support Team and Supervisors to develop educational tools and resources to increase employee knowledge of our regulatory environment.·Monitor oral grievances taken by Customer Service Specialists. Check daily for new cases, review cases for complete documentation, monitor timely and complete resolution of the case. ·Assist with responding to investigative requests from both internal and external partners. ·Review updates and notes in Compliance 360 distributed by Government Relations and determine impact, if any, on Customer Service.·Represent Customer Service as needed in inter-department meetings and assist call center leadership in identifying and prioritizing impacts to customers.·Collaborate with Government Relations & Compliance reviewing CMS/DHS/NCQA changes and performance reports, communication on compliance and control outcomes.·Assist in the development and annual review of all policies and procedures and CS letter templates to ensure alignment with regulatory guidelines. ·Other projects and duties as assigned.EducationHigh school graduate or equivalent. Two year degree in health related or insurance field with medical terminology course is preferred.Required ExperienceStrong organizational knowledge and experience with UCare technology systems & tools. High level understanding of Medicare/Medicaid products. Preferred ExperienceTwo to four years of call center experience in health insurance, HMO preferred. Knowledge of Microsoft Office and Microsoft Excel.THE UCARE DIFFERENCEUCare 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.
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.