CCO Configuration Manager

Minneapolis, Minnesota
Nov 12, 2020
Dec 24, 2020
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.


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.




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 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.


Position Description

This position is responsible to manage the coordination and administration of configuration management activities related to claims, pricing, benefits, authorizations, provider data, provider payment, correspondence, and user messages. Formulate procedures for and executes the introduction of changes to Amisys and HealthRules claims processing systems. Monitor the review of change data and change documentation activities to ensure adherence to configuration management procedures and policies. Ensure projects are completed on time. Act as advisor to the configuration analysis team regarding projects, tasks, and operations. Monitor and track all Configuration Team activities to ensure standards are being followed with proper documentation, reviews and approvals, testing and auditing, status of work and communication.

• Recruit, develop, mentor and evaluate staff. Establish, communicate and enforce performance standards.

• Identify training and coaching needs of staff. Develop and implement training / mentoring plans to best meet departmental and individual needs or goals.

• Direct staff workflow and performance to ensure adherence to service level objectives, policies and procedures.

• Develop, implement and maintain policies and procedures, work instructions, and other documentation to establish clear expectations for staff.

• Ensure timely and accurate pricing, benefits, authorization, provider data, provider payment, HCC and Validation Policy configuration to support provider and member contracts, state and federal guidelines and UCare pricing, coverage and medical policy.

• Develop strategies to simplify and improve configuration to be more efficient and streamlined.

• Partner with the business analysts and technical business analysts to gather, validate, and translate business requirements into technical requirements.

• Interface across broader Operations teams to understand and prioritize improvement areas, and proactively drive changes that will increase team efficiency and accuracy.

• Support organization with escalation support for claims-related inquiries with a root cause in configuration.

• Participate as key departmental liaison or lead for interdepartmental committees and work groups, as assigned.

• Communicate status, accomplishments and risks regularly and/or as needed to departmental leadership.

• Other projects and duties as assigned.


Bachelor's degree in business or related field; demonstrated work experience may be considered in lieu of degree.

Required Experience

Five years supervisory/managerial experience. Two years' experience in Medicaid, Medicare, and managed care organization. Project management experience. Experience with business process improvement.

Preferred Experience

Experience using Business Objects. Ability to build and maintain relationships across the enterprise. Strong knowledge of government programs, regulations and benefits. Previous experience with CMS, DHS or payer reimbursement methodologies and /or payment policies. Knowledge of or experience with Optum Claims Editing System (CES) and PPS.


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.

Job Post Date: 11/11/2020

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