UCare

Provider Enrollment Supervisor

Employer
UCare
Location
Minneapolis, Minnesota
Posted
Dec 05, 2021
Closes
Jan 08, 2022
Ref
2685
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.

PROVIDER ENROLLMENT SUPERVISOR

Work Location: 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 the oversight, analysis, design, implementation, and maintenance of provider enrollment data in UCare claims platforms, Amisys and HealthRules. Identify, evaluate, and implement processes to improve efficiency, effectiveness, and quality of provider data. Hire, supervise, train, develop, mentor, and evaluate Provider Enrollment team. Ensure compliance of provider data and department operations with state and federal guidelines. Support the strategy and business needs of UCare.

• Recruit, coach, mentor and manage a high-preforming team of professionals to facilitate provider data setup and ensure data is being entered following the provider contracts for quick and accurate claims adjudication.

• Oversee team production of multiple work streams and plan for workload fluctuation to ensure a high level of internal and external service within the set timelines. Forecast and communicate workload fluctuations with leadership through data analysis, reporting, and understanding of team dynamics. Work with internal and external provider data teams to rapidly resolve provider issues.

• Responsible for non-participating, out of network provider claims system processes as it relates to timely and accurate collection of necessary provider information and entry into the applicable systems. Serve as subject matter expert and escalation point for non-par provider setup, and communication issues. Organize cross departmental teams to ensure consistent and transparent processes. Coordinate non-par provider process issue resolution with UCare stakeholders

• Guide, implement, and manage training plans to best meet departmental and individual training needs. Identify training needs of staff. Develop and implement training plans to best meet departmental and individual training needs and goals. Set and communicate team member performance expectations.

• Govern team policies and procedures, work instructions, and other documentation to establish clear expectations for staff and cross functional business partners.

• Serve as the Provider Enrollment lead/owner of provider data set up in claims payment systems to ensure staff are documenting appropriately and collaborating with contracted providers as necessary.

• Provide work direction and ensure adherence to service level objectives, policies and procedures.

• Ensure timely and accurate implementation and maintenance of provider data to support: state and federal guidelines, contract implementation, and accurate provider payments.

• Assist in identification, implementation, monitoring and reporting on strategies to improve the operational efficiencies and quality of department workflows.

• Provide regular status reporting of departmental activities and operational metrics.

• Participate on assigned UCare committees and work groups to represent departmental interests. Regularly engage departmental staff as needed to meet committee objectives and report to department leadership and staff as appropriate.

• Support strategic and operational efforts as needed.

• Other projects and duties as assigned.

Education

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

Required Experience

Four years of experience in an insurance organization. Experience with business process improvement.

Preferred Experience

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

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: 12/03/2021

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