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.
CONFIGURATION AND CLAIMS OPERATIONS (CCO) DIRECTOR - OPERATIONAL EFFECTIVENESS
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.
As the Configuration & Claims Operations (CCO) Director - Operational Effectiveness, you will be responsible for leading and improving department performance and analyzing, automating, measuring and improving processes in support of UCare and CCO's Growth, Financial, Operational and Technical Strategies and Plans, in accordance with all applicable regulatory requirements. You will be responsible to ensure optimal transparency and communication of issues, risks, opportunities and key measures within CCO and with key stakeholders. As the organization continues to grow, this individual will see increased responsibility for the transformation of our business operations, including but not limited to, change management and communication, organizational design and structure, and role creation.
• Accountable for department business analysis, data analysis, workforce management, audit and compliance and stabilization and optimization efforts.
• Accountable for the development, maintenance and continual improvement of CCO work intake processes, including prioritization, escalation and determination of analytical rigor required.
• Accountable for the development and maintenance of department key measures, including a balanced scorecard. Ensure targets, service-level agreements and results are communicated to CCO internal and external stakeholders.
• Accountable for the definition and delivery of CCO department projects, ensuring scope and deliverables meet stated quality and timeliness objectives. Responsible to coordinate and oversee CCO support of UCare portfolio projects.
• Accountable for the development and maintenance of the CCO process architecture, CCO policies, controls, and audits. Ensure that processes, policies and procedures adhere to contractual and regulatory requirements and support efficient CCO operations.
• Assist in the development and execution of department plans and actions that are integrated with other departments and support the corporate strategic plan and UCare prioritized projects and initiatives.
• Collaborate with internal stakeholders to develop strategies to improve CCO processes and procedures, resulting in cost savings, operational risk reduction, and/or member and provider experience improvements.
• Participate as a member of the CCO Leadership Team. Ensure transparency and communication regarding metrics, performance, risks and issues across the team.
• Select, train, develop and evaluate staff and leaders to ensure desired performance. Establish and communicate clear performance standards.
• Serve on various UCare committees and workgroups.
• Other projects and duties, as assigned.
Bachelor's degree in health care field, business administration or related field. Master's degree preferred. Ten or more years of demonstrated experience may be considered in lieu of a degree.
Five years managerial/supervisory experience in a managed care organization or other health insurance environment. Seven years of experience with claims processing and/or configuration functions. Business analysis, process improvement and/or project management experience.
Familiar with Medicaid, Medicare, Dual and/or Commercial claim regulations.
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: 10/10/2022