UCare

CCO Compliance Coordinator

7 days left

Employer
UCare
Location
Minneapolis, Minnesota
Posted
Oct 02, 2021
Closes
Oct 26, 2021
Ref
2587
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.

CCO COMPLIANCE COORDINATOR

Work Location: Work from home, in the office 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 is responsible to provide operational support for analyzing and responding to regulatory and compliance requirements/inquiries. Conduct internal claim audits to ensure regulatory requirements as are met or initiate changes to meet requirements. Manage member correspondence process including templates, vendor issues, audits and reporting.

• Oversee Corrective Action Plans (CAPS). Provide timely updates, progress reports, respond to requests and report issues to non-compliance concerns to leader.

• Develop and maintain monthly reporting for incidents and 360 tasks. Distribute 360 tasks timely to appropriate person/team.

• Assist with inquiries, complaints, audits, and work instruction/job aid change requests.

• Point of contact for Compliance/Privacy/Fraud, Waste and Abuse (FWA) incidents.

• Manage end-to-end member correspondence process. Maintain process and policy documentation. Complete timely audits. Communicate and resolve correspondence issues. Report on results and findings. Identify opportunities for improvement.

• Evaluate audit results to ensure accuracy, validity and reliability of data.

• Manage project timelines and report on project status and results.

• Manage timely and comprehensive UCare Provider Manual updates on behalf of the CCO Audit & Compliance Team.

• Ensure compliance-related staff training is completed on time.

• Other projects and duties as assigned.

Education

Bachelor's degree in Business preferred; demonstrated work experience may be considered in lieu of degree.

Required Experience

Five years of Healthcare Operations experience. Three years of experience in system, process, and/or functional documentation and support, analysis procedures, change implementation, problem tracking and resolution, and other associated functional and operational management activities. HealthRules Payor training and/or experience.

Preferred Experience

Prior Medicaid/Medicare/Commercial regulatory experience. Experience with auditing and investigating company processes. Experience with writing, developing and implementing managed care policies and procedures.

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: 10/01/2021

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