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.

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 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.

VICE PRESIDENT, CONFIGURATION & CLAIMS OPERATIONS (CCO)

Work Location: Office for Your Day (Relocation package is available to non-local candidates)

ACCEPTING APPLICATIONS THROUGH FRIDAY, SEPTEMBER 30th, 2022

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

As the Vice President of Configuration and Claims Operations (CCO), you will be a member of UCare's leadership team, reporting to the Executive Vice President and Chief Administrative Officer. Major responsibilities include providing strategic direction and oversight for UCare's Configuration and Claims functions. This includes managing end-to-end claims receipt, processing and payment to ensure it is timely, accurate, and efficient and meets all regulatory requirements for both state and federal programs. In addition, you are responsible for the recovery of inaccurately paid claims as a result of error, coordination of benefits or change in provider reimbursement. This position will also oversee provider enrollment, provider contract set up, pricing and benefits configuration for existing and newly developed products. Develop and implement process improvements to improve the quality and productivity of the claim and configuration work teams and improve member and provider experience.

• Provide strategic direction to CCO teams, ensuring those teams provide the appropriate focus on strategic initiatives, regulatory requirements, and day-to-day operational activities.

• Ensure the CCO teams have performance standards or metrics, and that their activities are geared toward achievement of those standards/metrics. Support an environment of continuous learning and process improvement to encourage greater efficiency and member and provider experience improvements.

• Along with other members of the Leadership Team, participate in the enterprise-wide strategic planning and department planning processes. Ensure CCO teams and department plans are aligned with UCare strategies and priorities and are implemented as planned.

• Collaborate with other members of the Leadership Team to share insights and ideas about end-to-end processes, ensuring this important cross-departmental work is appropriately prioritized and executed for UCare's benefit.

• Maintain effective reporting and documentation processes to ensure that activity and goal status are reported on a timely basis, and that administrative procedures are created and updated.

• Develop and manage the annual budgets; perform within the budget limits or approved variances.

• Maintain an effective management team through targeted recruitment, training, supervision, coaching and development activities.

• Develop and implement reporting processes and metrics to support organizational information requirements and reflect CCO Department performance.

• Retain, recruit and develop high-performing CCO leaders and staff. Provide coaching and recognition opportunities and create a workplace culture that ensures a positive and inclusive work environment and actively engaged team. Serve as a business owner on cross-departmental projects including projects that improve claims data, increase accurate, timely processing of claims, eliminate rework and increase provider and member satisfaction.

• Provide business ownership and oversight for vendored services including EDI, Subrogation, EOB/EOP, OHI, and Claims Editing.

• Other projects and duties as assigned.

Education

Bachelor's degree in health care, business administration or related field required. Master's degree preferred; demonstrated experience may be considered in lieu of a Master's degree.

Required Experience

At least ten years of progressive leadership experience in a Claims leadership role. At least ten years of experience with claims processing, coding and/or claims support functions. Solid experience and knowledge of Medicare and state program products and services.

Preferred Experience

Previous experience working with claims, configuration, or related operational functions.

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: 09/06/2022