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

UCare offers Medicare, Medicaid, Individual and Family health plans - powered by the hardest working people in the industry. Our people powered teams de-complicate, advocate and always go the extra mile to help our members. We serve with integrity, compassion and commitment to do right by members, providers and government partners. Above all, we come to work excited to provide members a path for the best health of their lives.

WORKING AT UCARE

Working at UCare is more than 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. Employees join UCare and stay because of the opportunity to have a purpose-driven job.

Our strong culture has established UCare as a Star Tribune Top 150 Workplace for 10 consecutive years since the awards program began. It's a culture that embraces innovative ideas, strategic partnerships, and exemplary customer and provider experiences. Working at UCare is being a part of a people powered team dedicated to making a real difference in the lives of our members and communities.

VICE PRESIDENT, CLINICAL SERVICES (VP, CLS)

Position Description

This position is responsible to provide leadership and vision to ensure overall execution of clinical programs for UCare members. Oversee the design, implement, and monitoring of activities and workflows related to medical management, that is, utilization management, care management, population health, and clinical initiatives to increase member satisfaction, optimize clinical outcomes, and promote financial effectiveness. Ensure achievement of program outcomes, contract goals, service delivery within budget and compliant with accreditation and regulatory requirements.

Lead various committees that guide the development, implementation, and monitoring of utilization management, care management and population health activities. Support providers and cross-functional teams in facilitating member care to enhance the quality of clinical outcomes and member satisfaction while managing the cost of care. Also, provide clinical leadership and representation for internal and external UCare business activities.

Accountable for the recruitment, development and evaluation of Clinical Services directors, managers and their respective staff, using effective coaching, training, and active management to ensure an engaged, effective, collaborative department. Also responsible for clinical quality, operational efficiency, fiscal management and strategic planning of Clinical Services.

• Participate as a member of the Leadership team in developing, implementing, and monitoring UCare's strategic plan. Collaborate with other departments in support of strategic directives.

• Lead data driven medical management initiatives that address cost, utilization, and quality of care for members, including internal medical management programs and those delegated to external agencies consistent with accreditation and regulatory requirements, benefit design, product plan, reimbursement methodology, and network design. Ensure the development of corresponding policies and or procedures.

• Collaborate with Quality Management department on clinical quality initiatives with providers, payers, and delegates, HEDIS improvement activities and clinical Star measures.

• Participate in the negotiation and maintenance of clinical contracts and delegation agreements that meet UCare's business needs and provide specific services to members. Develop and implement policies/procedures that support the contracts and ensure effective contract execution.

• Supervise Clinical Services' efforts in preparation and planning for internal and external audits. Respond to notices from Government Relations and Corporate Compliance. Direct efforts in the development and maintenance of oversight and tracking tools.

• Create and monitor the Clinical Services' budget, including expenditures associated with the expenses from/for delegated entities and contracted vendors.

• Oversee the department hiring, training, and supervision of employees of the Clinical Services department.

• Identify and conceptualize clinical initiatives and alternate care models, and support innovative clinical programs that will advance strategic goals and align with organizational strategic initiatives.

• Other projects and duties as assigned.

Education

BSN and current unrestricted Minnesota license required. Masters degree in a health related or public policy field preferred.

Required Experience

Ten years leadership experience in a health care delivery setting such as physician group practice, primary care clinic, health insurance, and HMO or community service agency. Experience and knowledge of state and federal health and managed care programs.

Preferred Experience

Experience in HMO or commercial insurance medical management desired.

THE UCARE DIFFERENCE

The UCare difference is our people power - employees actively working on the behalf of our members to get them access to the health care they need. We value and respect each individual's ideas and contributions, and provide the freedom to grow both personally and professionally. We are centrally located, and offer onsite education, equipment and wellness resources, and a myriad of volunteer activities. If you're looking for an inclusive environment that celebrates your people power, 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.