UCare

Enrollment Quality Lead

7 days left

Employer
UCare
Location
Minneapolis, Minnesota
Posted
Aug 29, 2020
Closes
Oct 03, 2020
Ref
2072
Category
Healthcare
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.

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 11 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.

ENROLLMENT QUALITY LEAD

Position Description

This position is responsible to ensure the completion, accuracy, and quality of UCare's enrollment functions from application receipt to ID card distribution. Review entered applications to validate quality and completeness, monitor the status of enrollment processes through completion, review and interact with stakeholders and vendors responsible for steps in the enrollment process, and serve as the enrollment liaison to departments outside of MBE.

• Assist MBE leadership in monitoring status of enrollment processes for all products. Support leadership and staff in ensuring that enrollment tasks are competed accurately and prior to Centers for Medicare and Medicaid Services (CMS) deadlines.

• Collaborate with MBE leadership to establish and maintain role and/or activity-based quality standards.

• Develop staff-level audits to ensure technical accuracy and competence. Document performance and provide coaching and/or training based on findings.

• Develop department-level audits to identify issues and trends; provide feedback and remediation support to department leaders, trainers, and staff.

• Analyze trends in staff and department performance to identify areas where increased automation, revised workflows, adjusted oversight, or other factors could positively affect accuracy and efficiency.

• Identify training opportunities and actively participate in improvement plans; collaborate with education team and department leadership to successfully implement new enhancements and products.

• Monitor data within enrollment systems for accuracy and identify and escalate issues when enrollment information is out of sync with other systems, such as billing or claims. Report data to internal and external partners.

• Coordinate key process improvement project activities. Drive project effort and facilitate project related meetings. Partner with upstream and downstream implementation teams to ensure seamless and predictable outcomes.

• Serve as subject matter expert on enrollment regulations. Remain current on regulations for Medicare, Medicaid, and commercial health insurance plans, with a particular focus on Medicare Advantage enrollment regulations and service levels.

• Develop and distribute detailed and summary enrollment quality reports.

• Other projects and duties as assigned.

Education

Bachelor's degree in business, industrial engineering, or healthcare-related field; demonstrated experience may be considered in lieu of degree.

Required Experience

Five years' experience in health plan and/or enrollment processing. Three years of business analysis and/or process improvement and quality assurance experience. Understanding of Commercial, Medicaid, and/or Medicare regulations and requirements. Advanced level skill in Excel, PowerPoint, Visio, and Access.

Preferred Experience

Process improvement and/or Lean Six Sigma experience. Health Plan Operations experience in Enrollment and/or Membership Data Management. Experience working with CMS and/or state health department regulations. Strong critical thinking and analytic skills.

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.

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