UCare

CCO Configuration Provider Data Management Supervisor

7 days left

Employer
UCare
Location
Minneapolis, Minnesota
Posted
Sep 15, 2022
Closes
Oct 08, 2022
Ref
3170
Category
Management
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 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.

CCO CONFIGURATION PROVIDER DATA MANAGEMENT SUPERVISOR

Work Location: Work from home or 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.

Position Description

As the Configuration Provider Data Management Supervisor, you will be responsible to provide supervisory oversight of the Provider Data Management Team on the CCO Configuration Team. You will manage the coordination and administration of configuration activities in partnership with the CCO Configuration Manager around all run the business activities and projects related to Provider Data Management. Activities include ensuring adherence of configuration principles and standards related to provider data on the HealthRules Claims Adjudication Platform. Monitor and track provider data management activities, intake requests, and escalations to ensure standards are being followed, such as: approval and review processes, testing and auditing mechanisms, job aide/checklist adherence, and deployment lifecycle for configuration updates. In addition, make sure system updates are completed by team according to quality measurements and standard Service-Level Agreements (SLA) as defined by leadership. Track and ensure projects are completed on time, as well as working with organizational stakeholders on prioritization and communication.

• Coach, mentor, and lead the Provider Data Management Team including establishing, communicating and enforcing performance standards for staff including goals and development plan creation, quarterly and annual reviews.

• Participate in the interviewing, hiring, orientation and training of staff.

• Direct staff work assignments, workflow and performance to ensure adherence to service level objectives, policies and procedures.

• Support, manage, and communicate escalation support for claims-related inquiries with a root cause in configuration.

• Collaborate with other organizational stakeholders to prioritize work intake, determine resource estimations, establish delivery deadlines for completion of workload, and communication support.

• Develop, implement and maintain policies and procedures, work instructions, and other documentation to establish clear expectations for staff.

• Ensure timely and accurate provider data is configured on HealthRules Payor for proper claims adjudication, state and federal compliance, accurate provider pricing, and adherence of coverage policies.

• Communicate status, accomplishments, and risks regularly and/or as needed to the Configuration Manager.

• Determine and monitor trends related to configuration activities to prevent the promotion of erroneous configuration into HealthRules Payor.

• Look for process and automation opportunities in collaboration with configuration manager to develop efficient and accurate system setup, in addition to increasing speed to market activities, and resource scalability

• Develop and have oversight of work intake and backlog dashboards, to provide leadership visibility into the health of team activities and determination of additional resource justification.

• Review newly designed and proposed system functionality and process changes to determine impacts to configuration resources and scalability impacts.

• Facilitate continued training, onboarding of new staff, goal development, resource management, and overall performance adherence.

• 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

Two years supervisory/managerial experience managing people/processes. At least five years of experience in a Healthcare Configuration role. At least two years HealthRules Payor experience. Two years experience in Medicaid, Medicare, and managed care organization. Experience with project management, process improvements, and procedural development.

Preferred Experience

Strong knowledge of government programs, regulations and provider data management. Previous experience with CMS, DHS or payer reimbursement methodologies and /or payment policies.

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: 09/14/2022

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