Delegated Business Services Specialist
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. DELEGATED BUSINESS SERVICES SPECIALIST
This position is responsible to oversee and monitor the delegated functions contracted through external entities. Responsibilities include delegate management and communications, program oversight and performance tracking. Provide representation surrounding internal and external activities or initiatives, oversee operational interfaces, facilitate cross-department initiatives, support development and planning initiatives, issue resolution, process improvement and development of policies and procedures. Collaborate with Delegated Business Services Manager, in order to secure and maintain competitive and compliant contractual relationships with assigned delegates in accordance with regulatory, operational and financial goals and standards.Collaborate with project leads, business analysts, end users and third party contacts to design, develop, implement and test software applications.·Provide oversight of contracts for assigned delegates. Assess and revise work plans, materials and policies and procedures, as needed. Monitor all performance measures. ·Participate in audits and monitor corrective action plans, as needed.·Ensure State/Federal and Internal Reporting Requirements are met by assigned delegates. Ensure internal validation of requested and required reports. Submit reports to regulators, as needed.·Collaborate with delegates to implement annual benefit changes. Participate on annual benefits implementation workgroups, as needed. Identify, adjust or create operational processes needed to support introduction of new UCare products and/or implementation of new benefits for existing products. Monitor implementation and testing of benefit changes. ·Participate on assigned UCare committees and work groups to represent departmental interests. ·Document and resolve issues identified by delegates or internal stakeholders with engagement from other UCare departments, as needed.·Other projects and duties as assigned.EducationBachelor's degree in health care management, business, or related field; demonstrated work experience may be considered in lieu of degree.Required ExperienceFive years of experience working in the managed care industry, in a health plan or health care organization with responsibility for program, product, business, account management and/or provider related functions (network analysis, contracting, reimbursement, etc). Experience working in a matrix environment and possess the ability to lead cross-functional teams or efforts. Knowledge of health plan functions including: product management, operations, marketing/sales, compliance, information systems, data analysis and clinical.Preferred ExperienceKnowledge of state, federal and dental health care programs. THE UCARE DIFFERENCEUCare 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.