Coverage Policy Program Manager

Minneapolis, Minnesota
Aug 23, 2018
Nov 07, 2018
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.


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 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.


Position Description

This position is responsible for leading business and operational efforts to develop and maintain detailed business requirements, coverage policies and other documents that support benefits administration for UCare's products.  Collaborate with Government Relations and Product Management to serve as subject matter experts for UCare on coverage issues.

·Develop and oversee a comprehensive program management plan and all associated project plans including: committee and workgroup roles/responsibilities, timelines and deliverables; resource requirements; decision documentation; communication plan; information-sharing with appropriate staff/departments.

·Lead the development, maintenance and initiation of implementation requests of new or modified coverage policies and other documents.

·Lead the Coverage Policy team by establishing, planning, and executing on timing, resources, and performance objectives.

·Communicate and present program status, issues and opportunities to committee, workgroup and key stakeholders.

·Develop yearly program goals and annual program assumptions, and ensure integration of these goals with corporate objectives.

·Develop a change control process and communicate the plan for changes that impact overall program annual goals.

·Assess program issues and areas of risk, and develop mitigation plans to assist in decision making.

·Participate in the development and continuous improvement of processes, procedures, and tools related to coverage policy program and portfolio management practices.

·Create a centralized repository of coverage and benefit information to support UCare business and claims adjudication rules.

·Provide leadership to coverage policy staff and various work groups and committees to support coverage policies and provide input into processes and workflows reliant on coverage policy outcomes.

·Collaborate with Core Program and other internal initiatives/departments to monitor and identify existing coverage issues and any upcoming changes. Determine the scope and impact of any changes to UCare's members, providers and internal departments and seek to implement changes as necessary.

·Other projects and duties as assigned.


Bachelor's degree in business or related field; demonstrated experience may be considered in lieu of degree.

Required Experience

Five years of experience in healthcare or other managed care setting with a focus on regulatory compliance and/or benefits administration.  Two years of experience leading large initiatives and teams.  Familiar with health care metrics and utilizing data to drive business decisions.  Proficient in Microsoft Office.

Preferred Experience

Consulting and Project Management experience. Prior experience within an HMO, PPO or other health plan New Business Development department. Prior experience within a Medicare Advantage, FFS or commercial insurance organization and/or a Medicaid managed care organization.


UCare is proud to be a recognized Star Tribune Top Workplace for the 9th 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.

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