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.

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

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.

HEALTHRULES IMPLEMENTATION LEAD

Position Description

This position is responsible to lead efforts of the Benefits and Authorization Workstream. Identify and implement requirements and improvements during the Core System replacement efforts for UCare's Medicare, Medicaid and Dual product implementations. This role requires a solid foundational knowledge of healthcare operations, product knowledge and the ability to work with business users to understand and gather requirements as well translating these requirements into high quality solutions. It is expected that this role brings creative thinking as well as demonstrated knowledge of leading teams through business process transformation to align with best practices.

• Interact with Business Sponsors, Business Owners, Project Team Members, Vendors, and Subject Matter Experts to understand the business problem and needs. Candidate must demonstrate: Initiative, Prioritization Skills, Detail Orientation, and Business Knowledge.

• Lead the design of the HealthRules benefits and authorization configuration in alignment with articulated business requirements.

• Collaborate with HealthEdge consultants and other Workstream leads and analysts to ensure designs and policies support a fully integrated member and provider experience.

• Serve as SME for benefit and authorization configuration requirements, understand data sources and necessary transformations and assist with configuration of HealthRules benefits, service categories and authorizations.

• Provide thought-leadership and end-user support for HealthRules and translates those needs into configuration, testing, and implementation. Participates in application implementations and tests end user processes. Assists with the creation of presentations and other materials for end-user training

• Identify potential process and/or technical improvements based on uniqueness of UCare systems and needs.

• Lead Communication across workstream and business teams. Act as a liaison between Core teams and Business and build strong relationships. Present status/results in front of a project team or organizational leadership. Provide best-in-class internal customer service according to UCare's customer service guidelines

• Create critical use cases and support UCare's UAT testing.

• Support Project Manager. Interact with assigned projects' Project Manager to track progress, identify risks, manage backlog and communicate status to leadership. As requested, Project Reporting, Risk Management, Project Management and Project Execution tasks may be assigned.

• Other projects or duties as assigned.

Education

Undergraduate degree; demonstrated work experience may be considered in lieu of degree.

Required Experience

Five years' experience with Claims Processing systems and operations. Three years of Benefit Configuration and Healthcare Analysis. Knowledge of and skills in HealthRules Payor Configuration.

Preferred Experience

Project management experience. Ability to build and maintain relationships across a large enterprise and matrix relationships. Strong knowledge of government programs, regulations and benefits.

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.