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 600,000 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
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 200 Workplace for 13 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.
DELEGATED BUSINESS SERVICES SPECIALIST
Work Location: Office for Your Day
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.
This position is responsible to oversee and monitor the delegated functions contracted through external entities. Responsibilities include delegate management and communications, program oversight and performance tracking. Provide representation surrounding internal and external activities or initiatives, oversee operational interfaces, facilitate cross-department initiatives, support development and planning initiatives, issue resolution, process improvement and development of policies and procedures. Collaborate with UCare Leadership, in order to secure and maintain competitive and compliant contractual relationships with assigned delegates in accordance with regulatory, operational and financial goals and standards.
• Provide oversight of contracts for assigned delegates. Assess and revise work plans, materials and policies and procedures, as needed. Monitor performance measures.
• Participate in audits and monitor corrective action plans, as needed.
• Ensure State/Federal and Internal Reporting Requirements are met by assigned delegates.
• Ensure internal validation of requested and required reports. Submit reports to regulators, as needed.
• Collaborate with delegates to implement annual benefit changes. Participate on annual benefits implementation workgroups, as needed. Identify, adjust or create operational processes needed to support introduction of new UCare products and/or implementation of new benefits for existing products. Monitor implementation and testing of benefit changes.
• Participate on assigned UCare committees and work groups to represent departmental interests.
• Document and resolve issues identified by delegates or internal stakeholders with engagement from other UCare departments, as needed.
• Other projects and duties as assigned.
Bachelor's degree in health care management, business, or related field; demonstrated work experience may be considered in lieu of degree.
Three years of experience working in the managed care industry, in a health plan or health care organization with responsibility for program, product, business, account management and/or provider related functions (network analysis, contracting, reimbursement, etc). Experience working in a matrix environment and possess the ability to lead cross-functional teams or efforts. Knowledge of health plan functions including: product management, operations, marketing/sales, compliance, information systems, data analysis and clinical.
Knowledge of and/or experience in delegated services including state and federal regulatory compliance.
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: 06/08/2022