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.
CASE MANAGER - MEDICARE AND IFP
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.
This position is responsible to implement UCare's case management programs across the continuum of health care. Partner with members and/or their family via telephone to engage, assess and develop, implement, and evaluate the plan of care. Collaborate with providers and community agencies to support the member's medical and social needs impacting health outcomes. Support UCare efforts with CMS Stars, HEDIS and NCQA.
• Provide telephonic case management; including: engagement, assessment and development, implementation, and evaluation of their plan of care.
• Implement UCare's NCQA Complex Case Management program as well as other case management initiatives.
• Understand and accurately interpret and apply relevant contractual requirements, policies, procedures and regulations for those members for which care management is a provided service.
• Collaborate with members and/or family member, primary care providers, clinic staff and other relevant agencies to assure appropriateness of service that meets member needs and supports desired outcomes.
• Complete assessment of assigned members. Collaborate with member/caregiver in the development of a care plan appropriate to the member's needs.
• Identify and monitor member needs, including needed preventive medical care, and significant change in condition which may warrant early intervention for medical problems, or transitions of care. Incorporate ethnic and culturally appropriate approaches to care planning as needed.
• Enter member information in the UCare's clinical documentation system. Documentation is accurate, thorough, and timely.
• Meet and maintain all established caseload and performance metrics.
• Attend internal and external meetings; may act as team representative on cross departmental meetings as assigned.
• Assist with CMS Star Rating initiatives and other project improvement planning as appropriate.
• Other projects and duties as assigned
Registered Nurse, BSN preferred. Current and unrestricted Minnesota license as an RN is required. Must obtain a current and unrestricted Wisconsin RN licensure within the first 6 months of employment.
Two years' experience in care coordination/case management across the continuum of health (hospital, clinic, home care, etc.) with primary emphasis in working with chronic medical conditions.
Managed care experience or commercial insurance experience. NCQA Complex Case Management preferred.
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: 08/25/2022