UCare

Quality Control Supervisor

Employer
UCare
Location
Minneapolis, Minnesota
Posted
Nov 05, 2021
Closes
Dec 01, 2021
Ref
2644
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.

QUALITY CONTROL SUPERVISOR

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 for direct supervision of the Claims and Data Auditing staff. Interview, train, develop, coach and mentor individual team members. Ensure claims and data are audited accurately, and work is completed timely and in compliance with regulations, policies and procedures, and job aids. Data auditing functions owned and supported by the Team include but are not limited to EFT/ERA banking, supplier maintenance, and more. Engage and collaborate with Configuration, EDI & Technical, Claims Operations Teams and other departments to respond to work inquiries, intake, triage and prioritize work.

• Recruit, interview, select and onboard team members. Monitor daily schedules and work assignments of staff. Monitor team audit results and work with individual team members to improve performance. Document and provide performance feedback to staff in a timely manner.

• Ensure consistent execution of claims auditing processes (e.g. Standard, Training, Target, High-Dollar, etc.).

• Assist with development of department and team goals. Ensure timelines are met by the team.

• Identify and implement process improvement opportunities to increase operational efficiency and reduce rework.

• Document team processes, progress, activities, production, quality and issues. Facilitate daily team standups.

• Collaborate with UCare training department to ensure work instructions are current. Communicate claims services updates and changes in a timely manner.

• Identify, monitor and appropriately escalate known issues and risks.

• Serve as backup for any team member.

• Other projects and duties as assigned.

Education

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

Required Experience

One year of supervisory experience. Two or more years of experience in Medicaid, Medicare, and managed care organization. Experience with business process improvement.

Preferred Experience

Provider billing or claims processing experience. Experience working with physicians and care systems. Experience with HealthRules Payor.

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: 11/04/2021

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