Coverage Policy Program Analyst Senior
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 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. COVERAGE POLICY PROGRAM ANALYST SENIOR Position Description This position is responsible to lead the identification, analysis, design and implementation efforts for Coverage Policy development. This position requires awareness of various stakeholders' business needs and an in-depth understanding of multiple factors contributing to and impacting new policy development and existing policy enhancements. Exercise independent judgment within broadly defined policies and practices to determine best methods for identifying organizational policy needs, accomplishing work and achieving policy objectives. Key liaison between the Coverage Policy team and other business partners and technical areas and will lead and provide expertise on policy analysis, requirements, and implementation, deployment and execution strategies. ·Assist with facilitation of all aspects of coverage policy development, including: planning sessions, problem/issue definition, stakeholder analysis, data analysis, solution generation, requirements documentation and policy implementation and execution. ·Identify, review and edit requirements, specifications, business processes and recommendations that support/impact Coverage Policy development. ·Provide analytics and consultative support to ensure policies are supported by data-driven decision making. ·Mentor and train colleagues with less experience on both the technical and business aspects of Coverage Policy development and implementation work. ·Consult with operations' teams to translate business requirements into processes and/or technical systems solutions for successful policy implementation. ·Monitor and track post-implementation performance of benefit and coverage policy changes to ensure outcomes are met in a manner that is consistent with business and regulatory requirements. ·Develop and maintain Coverage Policy SharePoint site. ·Develop and maintain Coverage Policy work intake tool. ·Anticipate and identify issues that could inhibit achieving policy goals and objectives. ·Provide oversight to the resolution of policy issues and leads implementation of corrective actions and mitigation strategies. ·Serve as a secondary resource for triaging and troubleshooting coverage questions and post-implementation issues. ·Other projects and duties as assigned. Education Bachelor's degree in Business Healthcare Administration or other relevant field; demonstrated experience may be considered in lieu of degree. Required Experience
Five years of experience in a health care or managed care setting (managed care, regulatory agency or health insurance) with three years' hands-on healthcare reporting and business analysis experience. Knowledge of relationships between health plans and providers, including detailed understanding of healthcare plans (commercial and government). Strong skills in SQL, Excel, and PowerPoint. Understand UCare systems and business processes. Familiarity with ICD-10, CPT, HCPCS and other code sets as they relate to healthcare plan benefits and claims payment administration. Excellent verbal and written communication skills, including the ability to graphically present complex data. Ability to work on multiple projects, deliver work products on schedule, and respond to new requests with fast turn-around, as needed.Preferred Experience Project management experience. Ability to work in a matrix environment. Microsoft Access experience. THE UCARE DIFFERENCE 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.