UCare

MBE Representative Senior - Medicare

7 days left

Employer
UCare
Location
Minneapolis, Minnesota
Posted
Sep 03, 2021
Closes
Oct 01, 2021
Ref
2536
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 12 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.

MEMBERSHIP REPRESENTATIVE SENIOR - MEDICARE

Work Location: In the office, work-at-home or hybrid (in the office 3 or more days per week)

The health and safety of our employees, members, providers, and our community is our highest priority. Therefore, all new employees are expected to be fully vaccinated against COVID-19 prior to starting at UCare, subject to limited exceptions such as for a sincerely held religious belief or for medical reasons.

Position Description

This position responsible for enrollment processes with a moderate level of complexity. Meet the needs of the department through distribution of w orkload and a focus on timely, accurate deliverables. Research, monitor data, reconcile, and update member records appropriately. Maintain a thorough understanding of the enrollment processes and systems to be able to support Representatives as requested. Serve as a department resource and liaison to provide accurate timely responses and resolution to inquiries and complaints from members, authorized parties, and internal departments is an important function of this role. Assist with department processing to meet deadlines and targets. Senior staff will be on assigned to a product team as their primary focus; however, work will not be restricted to one product depending on the department needs.

• Maintain a thorough understanding of duties and responsibilities of the Representative role to ensure appropriate back up support as requested.

• Maintain knowledge of enrollment requirements (all federal, state and contractual), processes and systems and ensure requirements and timelines are followed.

• Research data mismatches and update member information accurately and timely to ensure member eligibility records are accurate including critical pharmacy updates.

• Support the Late Enrollment Penalty (LEP) and Out of Area (OOA) processes including; Research issues, create letters, making determinations, data submission, monitoring the process, participating in Quality Assurance reviews and providing monthly status reports to the manager, respond to telephonic inquiries and written requests from the CMS reconsideration vendor regarding a beneficiary request for appeal of LEP. Review LEP and OOA guidance, update letters or forms through the material review process to ensure continued compliance, track status and approval and member outreach when needed.

• Manage Service Forms and member correspondence. Report trends/issues and assist in developing solutions.

• Research system issues, working to address discrepancies as identified and manage standard reports.

• Participate in process and quality improvement, department initiatives/plan and employee engagement. Provide input into department policies and procedures, including verifying Step by Steps work instructions.

• Assist in departmental reporting and communication to other UCare departments.

• Other projects and duties as assigned.

Education

Two-year degree preferred; demonstrated experience may be considered in lieu of degree.

Required Experience

Three years' experience in a health insurance plan or health care setting. Knowledge of Microsoft Office products, intermediate skill level with Excel spreadsheets. Experience in researching and resolving complex issues. Customer/member engagement.

Preferred Experience

Experience reading and interpreting regulations. Microsoft teams.

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.

JOB POST DATE: 09/02/2021

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